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

See Also
1. Dysfunctional Uterine Bleeding
2. Menopause
Indications: Evaluation for postmenopausal bleeding
1. Postmenopause without Hormone Replacement
2. Postmenopause on Hormone Replacement >6 months
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
Management: Based on biopsy
1. Endometrial hyperplasia without atypia
  1. Treat with Progestins
2. Cytologic atypia
  1. Hysterectomy
References
1. Apgar (2003) AAFP Board Review, Seattle

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.