Gynecology Book

http://www.fpnotebook.com/

Postmenopausal BleedingAka: Post-menopausal Bleeding, Uterine Bleeding after Menopause

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  1. See Also
    1. Dysfunctional Uterine Bleeding
    2. Menopause
  2. Indications: Evaluation for postmenopausal bleeding
    1. Postmenopause without Hormone Replacement
    2. Postmenopause on Hormone Replacement >6 months
  3. Evaluation Protocol
    1. Step 1: Evaluate for Endometrial Cancer
      1. Endometrial Biopsy or
      2. Transvaginal Ultrasound
    2. Step 2: Hysteroscopy indications
      1. Endometrial Biopsy with hyperplasia or atypia
      2. Endometrial stripe >4 mm
      3. Persistant Abnormal Uterine Bleeding
  4. Management: Based on biopsy
    1. Endometrial hyperplasia without atypia
      1. Treat with Progestins
    2. Cytologic atypia
      1. Hysterectomy
  5. References
    1. Apgar (2003) AAFP Board Review, Seattle

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