Prevalence of Normal, Premature, Early and Late Menopause and Its Correlation with Endometrial Thickness, Associated Postmenopausal Symptoms and Comorbidities on Ultrasound in Lahore

Abstract

Background: Menopause is a major reproductive milestone with important implications for gynecological, metabolic, and overall health, and variation in menopausal timing may be associated with differing endometrial and clinical profiles. Objective: To determine the prevalence of normal, premature, early, and late menopause and to evaluate their association with endometrial thickness, postmenopausal symptoms, and selected comorbidities on pelvic ultrasonography in women from Lahore. Methods: This cross-sectional observational study included 114 women presenting to major hospitals in Lahore. Participants underwent pelvic ultrasonography using transabdominal or transvaginal approaches as clinically indicated. Menopause was categorized by age at menopause into premature, early, normal, and late groups. Endometrial thickness, postmenopausal symptoms, and comorbidities were recorded on a standardized data sheet and analyzed using descriptive statistics and chi-square testing in SPSS version 24.0. Results: Normal menopause was the most prevalent type (55.3%), followed by early menopause (28.1%), late menopause (13.2%), and premature menopause (3.5%). Endometrial thickness of 1-5 mm was observed in 64.0% of participants. Menopause type was significantly associated with endometrial thickness (p<0.001), with 93.3% of women with late menopause demonstrating endometrial thickness greater than 5 mm. Postmenopausal symptoms were not significantly associated with menopause type, whereas postmenopausal bleeding was significantly associated with endometrial thickness (p<0.001). Hypertension, polycystic ovarian syndrome, and hormonal imbalance were significantly associated with menopause type, and diabetes was significantly associated with endometrial thickness (p=0.006). Conclusion: Menopause type in this cohort was significantly associated with endometrial thickness and selected comorbidities, while postmenopausal bleeding emerged as the symptom most strongly linked with thicker endometrium. These findings support the value of integrated ultrasound and clinical assessment in postmenopausal women.