Pelvic ultrasound on days 5 to 10 of menstrual cycle reduce the variability in endometrial thickness and may be helpful in the diagnosis of endometrial hyperplasia. On pelvic ultrasound, endometrial hyperplasia is characterized by a homogeneous increase in the endometrial thickness in the majority of patients. However, endometrial hyperplasia may also cause asymmetric or focal thickening with surface irregularity which should raise a suspicion for malignancy.^[1]

• Pelvic ultrasound on days 5 to 10 of menstrual cycle reduce the variability in endometrial thickness and may be helpful in the diagnosis of endometrial hyperplasia.
• The ultrasound appearance can be non-specific and may not be reliable to differentiate between hyperplasia and carcinoma.^[2]
• The pelvic ultrasound shows a homogeneous increase in the endometrial thickness. However, endometrial hyperplasia may also cause asymmetric or focal thickening with surface irregularity which should raise a suspicion for malignancy.^[1]
• On pelvic ultrasound, endometrial hyperplasia is characterized by:^[1]

Premenopausal

• An endometrial thickness of >15 mm is considered above normal during the secretory phase of menstrual cycle

Postmenopausal

• An endometrial thickness of >5 mm is considered abnormal

• On pelvic ultrasound, tamoxifen induced endometrial hyperplasia is characterized by thickened, irregular, and cystic endometrium.
• Changes tend to be subendometrial in location and may cause subendometrial cysts.^[3]
• The degree of endometrial thickening corresponds to the duration of tamoxifen therapy.^[3]

• 
  Endometrial hyperplasia^[4]
• 
  Endometrial hyperplasia^[4]
• 
  Endometrial hyperplasia^[4]
• 
  Endometrial hyperplasia^[4]

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