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Type: Journal article
Title: Assessment of abnormal bleeding in menopausal women: an update
Author: Oehler, M.
MacKenzie, I.
Kehoe, S.
Rees, M.
Citation: Post reproductive health, 2003; 9(3):117-122
Publisher: British Menopause Society
Issue Date: 2003
ISSN: 2053-3691
Statement of
Martin K Oehler, Ian MacKenzie, Sean Kehoe, Margaret CP Rees
Abstract: Peri and postmenopausal bleeding, with or without the use of hormone replacement therapy, is a common clinical problem. The exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with abnormal uterine bleeding. Transvaginal ultrasound measurement of endometrial thickness has become a routine procedure and an initial investigation in patients with abnormal uterine bleeding. There is debate as to whether a cut-off of 5 or 4 mm endometrial thickness should be employed. If the endometrial thickness is above these values, polyps have been diagnosed or the patient is presenting with recurrent bleeding, endometrial disease has to be excluded by histological assessment. Outpatient aspiration curettage has superseded dilatation and curettage, which was previously considered to be the gold standard for obtaining endometrial tissue, and provides the same sensitivity in detecting endometrial disease. Hysteroscopy allows visualisation of the uterine cavity and the opportunity for targeted biopsy and removal of endometrial polyps.
Keywords: Endometrial biopsy; endometrium; hysteroscopy; postmenopausal bleeding; transvaginal ultrasound
Rights: Copyright © The British Menopause Society
DOI: 10.1258/136218003100322341
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