Management of women with postmenopausal bleeding: evidence-based review
Article first published online: 17 OCT 2012
© 2012 Royal College of Obstetricians and Gynaecologists
The Obstetrician & Gynaecologist
Volume 14, Issue 4, pages 243–249, October 2012
How to Cite
Bakour SH, Timmermans A, Mol BW, Khan KS. Management of women with postmenopausal bleeding: evidence-based review. The Obstetrician & Gynaecologist 2012;14:243–249.
- Issue published online: 17 OCT 2012
- Article first published online: 17 OCT 2012
- endometrial carcinoma;
- endometrial sampling;
- endometrial thickness;
- postmenopausal bleeding;
- transvaginal sonography
- Patients with postmenopausal bleeding (PMB) have a 10–15% chance of having endometrial carcinoma; they should therefore be seen within 2 weeks of referral. Cervical and vulval cancers remain important components of the differential diagnosis and can only be assessed by clinical examination.
- There are well-developed and evidence-based strategies on how best to investigate women with PMB. These strategies are formulated in several guidelines.
- To understand that the completion of investigations of patients with PMB should include test performance and patient characteristics.
- To be able to evaluate the various investigations for women with PMB.
- To be able to describe the appropriate management of women with PMB on tamoxifen, and unscheduled PMB in women undergoing hormone replacement therapy.
- Incidental finding of thickened endometrium on transvaginal sonography (TVS) in asymptomatic individuals carries a management dilemma.
- Approach to benign pathology: should subsequent evaluation for benign abnormalities be performed after malignancy has been ruled out?
- Ongoing work and technology development will evolve our strategy in managing PMB.