Modern strategy in the diagnosis of postmenopausal bleeding

Abstract

The traditional practice of dilatation and curettage (D and C) for the evaluation of any amount of postmenopausal bleeding has been questioned. It is not the optimal investigation because of the potential risks of general anaesthesia and the failure of uterine curettage to diagnose endometrial pathology effectively. The introduction of a one-stop outpatient postmenopausal bleeding clinic using investigative procedures such as risk factor identification, transvaginal ultrasound imaging of the uterus and endometrium, endometrial aspiration and outpatient hysteroscopy in selected cases provides an optimal, safe and cost-effective strategy in the modern management of women with postmenopausal bleeding.