Management of Postmenopausal Bleeding

Postmenopausal bleeding is a common patient complaint that is encountered by all physicians and other clinicians of gynecologic care. The clinician faces the possibility that there exists an underlying malignancy, while knowing that, in most instances, the bleeding comes from a benign source. In years past, the gold standard of clinical investigation was the institution-based dilation and curettage (D & C), but there now exists a number of office-based methods for the evaluation of women with this complaint. The post-menopausal use of gonadal steroids for the treatment of menopausal symptoms (HRT) is often associated with endometrial bleeding. Although the number of women using these agents decreased in the first decade of the 21st century, reevaluation of the literature and the release of new studies have collectively suggested that such therapy may provide benefit in at least selected instances