Review of menstrual disorders in which a secretory endometrium was found

The 310 cases of abnormal uterine bleeding in which secretory endometrium was found are reviewed by age group, presenting symptoms, duration of symptoms, severity of bleeding, continued ovulation, medical treatment, parity, and results. Two unusual endometrial histologic patterns were identified: (1) abnormal stromal and/or glandular response to progesterone and (2) secretory hyperplasia. Twenty-eight per cent of all patients with an adequate follow-up eventually received a hysterectomy—14.8 per cent for bleeding alone. Hypermenorrhea was most likely to result in a hysterectomy, with metrorrhea least likely. Dating the endometrium placed approximately 50 per cent of the problems at the time of ovulation and 50 per cent at the time of menses. Those patients with an abnormal response to progesterone were most likely to have a hysterectomy.