ABSTRACT
From a practical viewpoint, failure rates of hysteroscopy are lower in postmenopausal women taking exogenous oestrogen, because the need for local anaesthesia and cervical dilatation is reduced. Compared with symptomatic postmenopausal women not receiving exogenous hormones, the prevalence of endometrial hyperplasia is similar (but is dependent on compliance with progestogen), but the incidence of endometrial cancer and atypical hyperplasia is lower (typically 5 per cent). ‘Functional’ endometrium is generally encountered with sequential HRT regimens, but atrophy is common if the endometrium has been subject to suppression from continuous progestogen. Structural lesions such as submucous fibroids may be more common as they are oestrogen dependent, but endometrial polyps appear with a comparable frequency in most studies.
