Endometrial thickness in post menopausal women without bleeding

[Stefanie Lee]

I’ve been referring to this SOGC guideline (from 2010, perhaps there is something more recent?): https://www.jogc.com/article/S1701-2163(16)34690-4/pdf

[Maitray D. Patel]

I don’t know of anything more recent, but those guidelines and recommendations are spot on in my opinion.  I particularly endorse the idea that not ALL polyps need intervention, particularly when small and asymptomatic.

The only proviso I would add is to really consider recommending consideration of reevaluation of the endometrium AFTER progestin administration for the asymptomatic perimenopausal woman or asymptomatic early postmenopausal woman (< 10 yrs from FMP) who has incidental endometrial thickness at or over 10 mm rather than simply recommending gynecologic consultation.  These woman are often being sent or seen by their primary care physician who may not be a gynecologist, and this simple maneuver will often result in resolution of the observation because it was related to unsloughed stimulated endometrium.  If the endometrium remains at/over 10 mm after the attempted medical curettage using progestin, then GYN consultation would be useful–but if it resolves, then GYN consultation isn’t really needed.