Question 14: PMB Flashcards
What are some causes of postmenopausal bleeding?
Endometrial atrophy, genital malignancies, polyps, endometrial hyperplasia, iatrogenic causes, infection, trauma.
What is the first-line investigation for postmenopausal bleeding?
Transvaginal ultrasound (if endometrial thickness >4mm, further investigation is needed).
What is considered the gold standard for investigating postmenopausal bleeding?
Endometrial biopsy to rule out malignancy and hyperplasia.
When is hysteroscopy with directed biopsy indicated in postmenopausal bleeding?
When polyps or focal lesions are suspected.
Which investigation can be done to screen for cervical pathology in cases of postmenopausal bleeding?
Pap smear.
What other investigations might be considered for postmenopausal bleeding?
Coagulation profile.
How is endometrial atrophy managed?
Topical hormonal creams, hormone treatment, and lubricants for sexual intercourse.
What is the treatment for simple endometrial hyperplasia?
Oral progestins, intramuscular depot injection, or Mirena intra-uterine system.
What is the management for endometrial polyps?
Resection under hysteroscope.
