Endometrial Abnormalities in Women with Abnormal Uterine Bleeding, Association with Obesity, Hormonal Disturbances, and Treatment Patterns. A Clinical Cross-Sectional Study

Abstract

Background: Abnormal uterine bleeding (AUB) is a prevalent gynecological disorder associated with significant morbidity and is frequently linked to endometrial abnormalities, hormonal disturbances, and metabolic factors such as obesity. Early identification of underlying endometrial pathology is essential to guide appropriate management and prevent progression to premalignant or malignant conditions.

Objective: To assess the range of endometrial abnormalities in women with AUB and to examine how they are related to obesity, hormonal derangements, and treatment patterns.

Methods: This cross-sectional study was conducted on 100 women presenting with AUB from January 2024 to January 2025 at the Department of Obstetrics and Gynaecology, Sandeman Provincial Hospital, Quetta, Pakistan. Clinical evaluation, body mass index (BMI) assessment, hormonal profiling (TSH, estrogen, progesterone), ultrasonography, and endometrial biopsy were performed. The analysis was conducted with SPSS version 26, and p < 0.05 was regarded as statistically significant.

Results: The average age of the participants was 38.9 ± 7.8 years, with 48.0% of them being obese. Abnormalities of the endometria were found in 70.0% of patients, with the most frequent pattern of hormonal imbalance (28.0%), proliferative (17.0%), and secretory endometria (13.0%). A diagnosis of endometrial hyperplasia was made in 9.0% of cases, and carcinoma was confirmed in 2.0%. Hormonal imbalances occurred in 56.0% of the patients, with hypothyroidism being the most prevalent (32.0%). Statistically significant correlation was found between endometrial hyperplasia and obesity (p = 0.02). In 65.0% of the patients, medical management was used, and 35.0% of the patients needed surgical intervention.

Conclusion: Hormonal imbalance and obesity are closely interrelated with endometrial abnormalities in AUB. Detailed testing, such as hormonal and histopathological examination, is essential in making a proper diagnosis and effective management.