Histomorphological pattern of Endometrium in different Age Groups presenting with Abnormal Uterine Bleeding (AUB): A Cross-Sectional Study

Abstract

Background: Abnormal uterine bleeding (AUB) encompasses any deviation in menstrual frequency, duration, or amount, and represents the most common gynaecological complaint leading to histopathological evaluation across all age groups. The histomorphological spectrum of endometrial changes varies considerably with age and hormonal status Objective: To evaluate the histomorphological pattern of endometrium and observe the incidence of various endometrial pathology patterns in different age groups presenting with abnormal uterine bleeding Materials and Methods: Across-sectional observational study was conducted in the Department of Pathology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan which included 115 cases of clinically diagnosed AUB. Histopathological examination of endometrium obtained from biopsy and hysterectomy specimens were clinically correlated with age groups. Statistical analysis was performed using SPSS version 25.0. A p-value <0.05 was considered statistically significant Results: The majority (36.5%) of the cases were seen in the 5th decade of life chiefly affecting the para 3–4 group. The most common gynecological symptom observed among patients with AUB was menorrhagia, accounting for 45.2% of the cases. Proliferative endometrium was the most common histopathological pattern (30.4%), followed by secretory endometrium (19.1%), endometrial hyperplasia (15.7%), and disordered proliferative endometrium (12.2%). Malignant lesions accounted for 7.0%. A statistically significant association was found between age group and endometrial causes of AUB (functional vs. organic; χ² = 10.81, p = 0.029), with a progressive shift from functional causes in younger to organic causes in older women. Conclusion: Histopathological evaluation of endometrium is indispensable in AUB management. Proliferative and secretory patterns predominate, while organic and malignant pathology increases significantly with advancing age particularly in peri-menopausal and postmenopausal groups, emphasizing the need for routine histopathological assessment especially in women aged 40 years and above.