Comparison of Endometrial Thickness Measurements in women with Normal and Abnormal Uterine Bleeding Using Ultrasonography
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Background: Abnormal uterine bleeding (AUB) is common among reproductive-age women and may arise from structural or nonstructural gynecological causes. Endometrial thickness (ET) can be measured noninvasively with ultrasonography, but interpretation in premenopausal women is complicated by physiological variation across the menstrual cycle. Objective: To evaluate endometrial thickness in women with normal and abnormal uterine bleeding and compare ET across menstrual-flow categories using ultrasonography. Methods: This comparative cross-sectional observational study included 80 women aged 20–45 years at Bahawal Victoria Hospital, Bahawalpur. ET was measured by transabdominal ultrasonography using a Toshiba Xario system with a 2.5–5 MHz probe in the midsagittal plane at the thickest portion of the endometrium. Menstrual characteristics, body mass index, cycle phase, uterine dimensions, and orientation were recorded. ET was compared among light, moderate, and heavy menstrual-flow groups using one-way ANOVA with Tukey post-hoc comparisons. Results: Mean age was 31.2±6.85 years. Sixty women (75.0%) were classified as having abnormal uterine bleeding and 60 (75.0%) reported heavy menstrual flow. Mean ET was 4.08±1.44 mm in the light-flow group, 5.74±1.17 mm in the moderate-flow group, and 12.63±1.22 mm in the heavy-flow group. The overall difference was substantial (F(2,77)=294.18, p<0.001; η²=0.884). Tukey comparisons showed differences of 1.66 mm between moderate and light flow, 8.55 mm between heavy and light flow, and 6.89 mm between heavy and moderate flow. Conclusion: Endometrial thickness differed markedly across menstrual-flow categories, with the greatest thickness observed among women reporting heavy flow. Because cycle phase was not controlled across groups and no histopathological reference standard was used, the findings demonstrate association rather than a diagnostic threshold for endometrial pathology.
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