Introduction/Background Perimenopausal transition includes the years before menopause that encompass the change from normal ovulatory cycles to cessation of menses. It begins when the clinical and/or biological signs that indicate the onset of menopause appear and ends at least one year after the last menstrual period.

Pelvic ultrasound is the first-line examination for the exploration of these lesions associated with hysteroscopy for better diagnostic accuracy.

The objective of our study is to evaluate and compare the contributions and performances of ultrasound and hysteroscopy in comparison with histology in the evaluation of endo-uterine lesions in women during the perimenopausal transition.

Methodology Our study is descriptive and retrospective, performed at the Department of Gynecology and Obstetrics I of the CHU Hassan II of Fez, spread over a period of one year, from 01/01 to 31/12. 46 perimenopausal patients, who had been consulted for genital bleeding, were investigated in our department by ultrasonography and hysteroscopy, the results of which were compared with those of histology. We have calculated in our study the sensitivity, the specificity, the positive and negative predictive values of ultrasonography and hysteroscopy.

Results Ultrasonography showed an endometrial thickness in 15 cases (32.6%), a uterine myoma in 13 cases (28.3%), an endometrial polyp in 7 cases (15.2%), adenomyosis in 6 cases (13%), an atrophic endometrium in 2 cases (4.3%), and a normal ultrasonography in 8 cases (17.4%).

Hysteroscopy showed an endometrial thickness in 39.1% of cases, a uterine myoma in 30.4% of cases, an endometrial polyp in 15.2% of cases, adenomyosis in 13% of cases, an atrophic endometrium in 15.2% of cases and a normal hysteroscopy in 6.5% of cases.

Conclusion The initial investigation in front of any intracavitary lesion during perimenopause is ultrasound. However, hysteroscopy is also useful for better diagnostic accuracy.

Disclosures The authors declare that they have no conflict of interest.