BMJ Case Reports 2018; doi:10.1136/bcr-2018-224533
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Infertility: an out-of-the-box cause of postmenopausal endometrial thickening

  1. Conceição Nunes
  1. Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  1. Correspondence to Dr Ana Portela Carvalho, ana.sofia.portela.carvalho{at}
  • Accepted 23 March 2018
  • Published 13 April 2018


The presence of intrauterine foreign bodies (IFBs) is a rare condition that may lead to chronic endometritis through local inflammation. According to literature, IFB may be the cause of 0.02% to 0.15% of the cases of infertility, and of abnormal uterine bleeding, pelvic pain and abnormal vaginal discharge.1

We present the case of a 63-year-old, nulligravida, postmenopausal woman who complained of scarce genital bleeding and vaginal discharge for about 1 year. The patient denied other symptoms like fever, pelvic pain, dyspareunia or weight loss. In terms of relevant previous history, this patient had a laparotomy and myomectomy performed 30 years before because of a transmural uterine leiomyoma diagnosed in the workup for primary infertility. Even after surgery, no pregnancy was achieved. Menopause occurred at 52 years of age and no hormonal replacement therapy was used. …

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