[CG] Asymptomatic endometrial thickening


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Increased endometrial thickness or fluid within uterine cavity as an incidental finding on imaging of postmenopausal women – investigation and management

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A perceived increased endometrial thickness or fluid seen within the uterine cavity are common incidental findings during unrelated investigations of postmenopausal women.

As long as the woman is asymptomatic with no postmenopausal bleeding, routine referral should be made for transvaginal ultrasound.

If transvaginal ultrasound confirms the finding of thickened endometrium or fluid in the cavity, the postmenopausal bleeding guideline should be followed (pipelle for women with thin endometrium but fluid in cavity, hysteroscopy for women with thickened endometrium).

NB: 70-80% of women taking Tamoxifen will have a thickened appearance to the endometrium on imaging. This does NOT require further investigation unless there has been bleeding in which case urgent referral should be made.

[CG] Post menopausal bleeding, investigation of

Last reviewed: 04 February 2020

Next review: 28 February 2025

Author(s): Claire Higgins

Approved By: Dr R. Jamieson, Clinical Director