To evaluate hysteroscopic findings in women with postmenopausal bleeding and correlate them with histopathological results of the endometrium., Sohag University Hospital Obstetrics and Gynecology department

Inclusion criteria :

• Postmenopausal women presenting with uterine bleeding

• Age ≥ 45 years

  *Exclusion criteria:

• Women on hormone replacement therapy

• Bleeding due to vulvar, vaginal, cervical, or urethral causes

• Patients on anticoagulant therapy

• Patients unfit for hysteroscopy

• Refusal to participate

All patients in this study will be subjected to the following (as detailed in the attached patient's data sheet).

I. Clinical Assessment

• Detailed history including:

  • Duration since menopause
  • Pattern and duration of bleeding
  • Obstetric and medical history

• General abdominal and pelvic examination

II. Transvaginal Ultrasound (TVS)

• Measurement of endometrial thickness
• Assessment of uterine and adnexal pathology

III. Hysteroscopic Examination

Hysteroscopy will be performed using a rigid hysteroscope to evaluate:

• Endometrial appearance
• Presence of polyps, hyperplasia, or malignancy

Hysteroscopic findings will be classified as:

• Normal (proliferative, secretory, atrophic)
• Abnormal (polyp, hyperplasia, carcinoma, fibroid) (1,3)

Criteria suggestive of:

• Hyperplasia: irregular thickened endometrium, increased vascularity (1,3)
• Carcinoma: irregular necrotic tissue, atypical vessels, friable surface (1,3)

IV. Endometrial Sampling

• Directed biopsy will be taken from su