Many postmenopausal women with thickened endometrium but no bleeding could safely avoid hysteroscopy if the threshold for it was increased to a thickness of 9mm, an Australian study finds.

Melbourne gynaecologists say this new trigger for endometrial sampling in asymptomatic patients can detect malignancy with greater accuracy than the current >4mm cut-off.

“The data from this study strengthen the recommendation against routine hysteroscopic evaluation of asymptomatic women with [endometrial thickness of] <9mm,” wrote the team, led by Dr Samantha Mooney at the Mercy Hospital for Women. 

In their single-centre retrospective case series, Dr Mooney and colleagues reviewed data from 404 asymptomatic, postmenopausal women (mean age 65) undergoing hysteroscopy to determine a “reasonable” endometrial thickness to prompt further assessment.