Endometrium with changes due to exogenous hormones

Endometrial changes of oral contraception
External resources
EHVSC	10170

Endometrium with hormonal changes is relatively common in endometrial samples.

Endometrial changes of oral contraception, oral contraceptive effect and OCP endometrium redirect here.

The oral contraceptive pill is dealt with in the article oral contraceptive pill.

General

• Very common.
• Most pills a mix of progesterone and estrogen.
  • The progesterone is what generates the characteristic appearance -- that is similar to pregnancy.

Microscopic

Features:

• Inactive glands (round/ovoid glands, simple cuboidal epithelium, no mitoses).
• Stroma decidualized -- mnemonic NEW:
  • Nucleus central.
  • Eosinophilic cytoplasm.
  • Well-defined cell borders.

DDx:

• Endometrial hyperplasia with secretory changes - proliferative activity.
• Secretory phase endometrium - glandular changes of the secretory phase (cytoplasmic vacuolization), secretions in the glands.

Image

• 

  Endometrium of woman on an OCP. (WC/Nephron)

Sign out

ENDOMETRIUM, BIOPSY:
- NON-PROLIFERATIVE ENDOMETRIAL GLANDS WITH STROMAL DECIDUALIZATION, CONSISTENT 
  WITH EXOGENOUS HORMONES.

OCP effect and shedding endometrium

ENDOMETRIUM, ASPIRATION:
- ENDOMETRIUM WITH NONPROLIFERATIVE ENDOMETRIAL GLANDS AND
  STROMAL DECIDUALIZATION, COMPATIBLE WITH EXOGENOUS HORMONES.
- EVIDENCE OF ENDOMETRIAL SHEDDING (BALLS OF CONDENSED STROMA
  ASSOCIATED NEUTROPHILS, AND BLOOD).
- NEGATIVE FOR HYPERPLASIA AND NEGATIVE FOR MALIGNANCY.

See also

• Endometrium.
• Endometrial hyperplasia with secretory changes.