Relationship Between Transvaginal Ultrasound Endometrial Thickness, Body Mass Index and Endometrial Pathology in Women with Post-Menopausal Bleeding

Postmenopausal bleeding is any vaginal bleeding occuring at least 12 months after the last menstrual period in women aged above 45 years who are not taking hormone replacement therapy. It is most commonly attributed to an intrauterine source, but may also originate from other gynaecological or non- gynaecological sources, such as the cervix, vagina, ovaries, bladder, urethra or lower gastrointestinal tract. Aim to find the potential relationship between transvaginal ultrasound endometrial thickness, body mass index and endometrial pathology in women with postmenopausal bleeding. A cross-section study was conducted in Alzahraa Maternity and Paediatrics Teaching Hospital / Najaf Governorate / Iraq, during the period from the 1st of January to the 1st of December 2025. The current study included a convenient sample of 50 women who presented with postmenopausal bleeding and were indicated and scheduled to undergo an endometrial biopsy.  Results of the participants, 48% were overweight and 34% were obese. Endometrial hyperplasia without atypia (52%) was the most common histopathological finding, followed by endometrial polyps (34%). Body mass index was significantly higher in women with malignancy or atypical hyperplasia and positively correlated with endometrial thickness (P=0.001). Obesity was associated with increased endometrial thickness and a higher risk of premalignant and malignant endometrial pathology in women with postmenopausal bleeding.