Endometrial pathology and estrogens

Endometrial biopsies were obtained from 46 hypogonadal patients (44 with gonadal dysgenesis; 2 panhypopituitary) who were receiving estrogen-progestogen therapy. Endometrial abnormalities occurred only in patients receiving a total lifetime conjugated estrogen dose of ≥2500 mg and who had received estrogen treatment for a period longer than 4.2 years. The biopsy outcome was significantly related (P<0.01) to the estrogen dose at time of biopsy and to the total lifetime dose (P<0.05). The progestational drugs administered did not protect against development of endometrial abnormalities. None of the abnormal endometrial patterns were associated with abnormal vaginal bleeding.