One hundred and seventy seven women with peri- and postmenopausal bleeding were subjected to vaginosonographic examination followed by thorough pathological examination of the uterine curetting samples. A mean endometrial thickness (double layer) of 13.2 +/- 3.6 mm and 8.2 +/- 4.8 mm were found in those with and without histological abnormalities, respectively. Endometrial thickness of less than 7 mm, however, was found to be predictive of normal endometrium (100% sensitivity, 46% specificity) and can, therefore, be used to separate those who require diagnostic curettage from those who do not. These findings suggest that this relatively simple, noninvasive procedure can be used as a screening test for patients with peri- or postmenopausal bleeding.