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Diagnosis and Management of Postmenopausal Bleeding

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Handbook of Gynecology

Abstract

Postmenopausal bleeding refers to any uterine bleeding that occurs after a woman reaches menopause and accounts for up to 5 % of gynecological office visits. Excluding an endometrial malignancy is the key component to the work-up. Ultimately, the management of these patients is dictated by the diagnosis. The differential diagnosis ranges from gynecologic causes to non-gynecologic causes, including urologic and gastrointestinal etiologies.

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References

  • American College of Obstetricians and Gynecologists. The role of transvaginal ultrasonography in the evaluation of postmenopausal bleeding. ACOG Committee Opinion No. 440. Obstet Gynecol. 2009;114:409–11.

    Article  Google Scholar 

  • American Society of Clinical Oncology: Lynch Syndrome. [approved 12/2014]. Available from http://www.cancer.net/cancer-types/lynch-syndrome

  • Astrup K, Olivarius NF. Frequency of spontaneously occurring postmenopausal bleeding in the general population. Acta Obstet Gynecol Scand. 2004;83(2):203.

    Article  PubMed  Google Scholar 

  • Ben-Arie A, et al. Does hysteroscopy affect prognosis in apparent early-stage endometrial cancer? Int J Gynecol Cancer. 2008;18:813–9.

    Article  CAS  PubMed  Google Scholar 

  • Burbos N, et al. Age-related differential diagnosis of vaginal bleeding in postmenopausal women: a series of 3047 symptomatic postmenopausal women. Menopause Int. 2010;16(1):5–8.

    PubMed  Google Scholar 

  • Burbos N, et al. Outcome of investigations for postmenopausal vaginal bleeding in women under the age of 50 years. Gynecol Oncol. 2012;125(1):120–3.

    Article  PubMed  Google Scholar 

  • Dijkhuizen FP, Mol BW, Brölmann HA, Heintz AP. The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer. 2000;89(8):1765.

    Article  CAS  PubMed  Google Scholar 

  • Endometrial Cancer. ACOG Practice Bulletin Number 149. Obstet Gynecol. 2015;125(4):1006–26.

    Google Scholar 

  • Hanegem N, et al. Diagnostic evaluation of the endometrium in postmenopausal bleeding: an evidence-based approach. Maturitas. 2011;68(2):155–64.

    Article  PubMed  Google Scholar 

  • Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer. 1985;56(2):403.

    Article  CAS  PubMed  Google Scholar 

  • Moodley M, Roberts C. Clinical pathway for the evaluation of postmenopausal bleeding with an emphasis on endometrial cancer detection. J Obstet Gynaecol. 2004;24(7):736.

    Article  CAS  PubMed  Google Scholar 

  • Takac I, Zegura B. Office hysteroscopy and the risk of microscopic extrauterine spread in endometrial cancer. Gynecol Oncol. 2007;107(1):94–8.

    Article  PubMed  Google Scholar 

  • Trimble CL, et al. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer. 2006;106(4):812–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Trevin C. Lau

  2. Obstetrics and Gynecology, University of Florida, College of Medicine, 1600 SW Archer, Gainesville, FL, 32610, USA

    Lisa B. Spiryda

Authors
  1. Trevin C. Lau
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  2. Lisa B. Spiryda
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Corresponding author

Correspondence to Trevin C. Lau .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology and Family Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA

    Donna Shoupe

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© 2015 Springer International Publishing Switzerland

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Lau, T.C., Spiryda, L.B. (2015). Diagnosis and Management of Postmenopausal Bleeding. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-17002-2_46-1

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  • DOI: https://doi.org/10.1007/978-3-319-17002-2_46-1

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  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-17002-2

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