Endometrial Biopsy Not Needed Before HRT

Women are sometimes asked to undergo an endometrial biopsy to rule out occult adenocarcinoma before starting hormone therapy. This study categorized the results of endometrial biopsies performed on 2964 postmenopausal or perimenopausal women (mean age, 52) who were candidates for hormone therapy. The women had not had any menstrual bleeding for an average of 29 months before the biopsy.

Only 2 women (0.07%) had an occult adenocarcinoma, while 196 (6.6%) had insufficient tissue to diagnose uterine abnormalities. Over two thirds of the women had an atrophic endometrium, and about a quarter had an endometrium in the proliferative phase.