Ovarian volume assessment in relation to histologic findings and sex hormone levels in women with postmenopausal bleeding and thickened endometrium

BACKGROUND AND OBJECTIVES: In postmenopausal women, ovarian stromal hyperplasia and endometrial cancer are often identified concurrently. The aim of the present study was to verify the association of ovarian volume with histologic findings and sex hormones levels in women with postmenopausal bleeding and thickened endometrium. DESIGN AND SETTING: Prospective observational study conducted in a teaching hospital between March 2008 and February 2010 PATIENTS AND METHODS: Ninety women with postmenopausal bleeding and thickened endometrium (≥5 mm) were enrolled. They underwent vaginal sonography for ovarian volume measurement. Blood samples were collected for sex steroid hormones assay. In addition, endometrial sampling was done for definitive histologic diagnosis. RESULTS: According to histologic results, 18 cases (20%) had endometrial adenocarcinoma, 24 cases (26.7%) had endometrial hyperplasia with or without atypia and 48 cases (53.3%) had benign histologic findings. Large ovaries were significantly associated with higher body mass index (BMI≥30) (P=.002) and endometrial adenocarcinoma (P<.001). After adjustment for age and BMI, increased ovarian volume in adenocarcinoma was associated with high serum level of estradiol (P<.001), serum total testosterone (P=.04) and serum free testosterone (P<.01) compared with other histologic findings. CONCLUSIONS: Large ovaries among women with postmenopausal bleeding and thick endometrium were associated with elevated serum sex steroid hormones and represent a marker of risk for endometrial adenocarcinoma.