Bleeding after the menopause or irregular bleeds in the forties and fifties requires careful assessment by a gynaecologist. Before the menopause, hysteroscopy and endometrial biopsy or curettage are required (Q 24.12). Transvaginal ultrasound can be of value after the menopause. If the endometrium is no more than 4mm thick and appears normal, further investigation may not be required.

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Women's Health