Is there a need to investigate vaginal bleeding after the menopause?

Br J Obstet Gynaecol. 1991 May;98(5):470-5.

The role of vaginal scan in measurement of endometrial thickness in postmenopausal women.

Authors:

Nasri MN , Shepherd JH , Setchell ME ,

Lowe DG , Chard T .

St. Bartholomew's Hospital, West Smithfield, London.

Transvaginal ultrasound scanning was performed on 111 postmenopausal women. Of these women, 103 had postmenopausal bleeding, and eight were undergoing hysterectomy. Of the 103 women with bleeding, 93 had dilatation and curettage (DandC) and 10 patients were treated conservatively with a repeat scan in six months. A correlation of ultrasound findings and endometrial histopathology was possible in 94 patients. In 59 of these (63%) the endometrium was atrophic and the ultrasound endometrial thickness was 5 mm or less. In 29 (31%) patients the endometrial histology was abnormal and ultrasound endometrial thickness was greater than 5 mm. In six patients the endometrium was atrophic, but the ultrasonic endometrial thickness was apparently greater than 5 mm due to intracavity fluid. We suggest that an endometrial thickness of 5 mm is an appropriate cut-off level for conservative management of patients with postmenopausal bleeding, or in screening for endometrial carcinoma.

Please click on the required question.