Post Menopausal Bleeding/ abnormal uterine bleeding

Question 1

What is the most common cause of menorrhagia?

Answer 1

Ovulatory dysfunctional uterine bleeding

Question 2

What do you need to rule out when discussing abnormal uterine bleeding?

Answer 2

Pregnancy or pregnancy complications eg ectopic pregnancy
Trauma of the genital tract
Medical disorders eg bleeding disorder
Endocrine disorders
Cancer of the genital tract
Complications of the OCP

Question 3

What is the most effective agent for both ovulatory and anovulatory dysfunctional uterine bleeding?

Answer 3

Tranexamic acid

Question 4

True or false: intermenstrual bleeding should always be investigated

Answer 4

True

Question 5

What are the risk factors for endometrial cancer?

Answer 5

Age (peak incidence 50-70)
Obesity
Nulliparity
Late menopause
Diabetes mellitus
Polycystic ovary
Drugs eg unopposed oestrogen, tamoxifen
Family history- breast cancer, colon cancer

Question 6

What are two common organic causes of menorrhagia?

Answer 6

Fibroids and adenomyosis

Question 7

What is post menopausal bleeding?

Answer 7

Any bleeding occurring 6 months or more after menopause

Question 8

What are some causes of post menopausal bleeding?

Answer 8

25% cervical or uterine body cancer
Polyps
Atrophic vaginitis
Endometrial hyperplasia