What is the implication of the endometrial stripe measuring greater than 4mm during a transvaginal ultrasound?

A measurement of the endometrial stripe greater than 4mm during a transvaginal ultrasound is significant and often raises concern for conditions such as endometrial hyperplasia or carcinoma. In postmenopausal women, an endometrial thickness of more than 4mm is considered abnormal and may warrant further investigation due to the increased risk of malignancy. The endometrium typically thins after menopause, so this thickening might suggest an abnormal proliferation of cells, leading to hyperplasia or even cancer.

In premenopausal women, the interpretation can vary depending on the phase of the menstrual cycle. However, if an abnormal measurement is noted, particularly in the context of abnormal uterine bleeding or other risk factors, endometrial pathology should be evaluated.

While a thickened endometrial stripe can occasionally be seen in conditions like uterine fibroids or in early pregnancy, the specific concern for endometrial hyperplasia or carcinoma is what makes this measurement particularly critical for further evaluation and management.