Post-menopausal Bleeding Flashcards Preview

B - Gynaecology > Post-menopausal Bleeding > Flashcards

Flashcards in Post-menopausal Bleeding Deck (18)
1

What is the definition of post-menopausal bleeding?

Vaginal bleeding occurring after 12 months of amenorrhoea at an age where menopause is to be expected

2

When can post-menopausal bleeding be applied to younger women?

When the woman has premature ovarian insufficiency or premature menopause

3

What is unscheduled bleeding?

Non-cyclical bleeding still occurring 6 months after commencing HRT or after 6 months of amenorrhoea

4

What are the possible causes of post-menopausal bleeding?

- Vaginal atrophy
- Use of HRT
- Endometrial hyperplasia
- Endometrial cancer
- Endometrial or cervical polyps
- Cervical, ovarian, vaginal or vulval cancer
- Non-gynaecological causes

5

What is the most common cause of post-menopausal bleeding?

Vaginal atrophy

6

What are the possible non-gynaecological causes of post-menopausal bleeding?

- Trauma
- Bleeding disorders

7

How should post-menopausal bleeding be treated until proven otherwise?

As malignant in nature

8

What is the first management step for any post-menopausal bleeding?

Appointment with gynaecologist within 2 weeks

9

What is the first line investigation in post-menopausal bleeding?

Transvaginal USS

10

What does transvaginal USS in post-menopausal bleeding help to identify?

Women at risk of endometrial cancer (and endometrial hyperplasia)

11

How does thickness of endometrium in post-menopausal women relate to the likelihood of serious pathology?

Thicker = more likely

12

What is the threshold for further investigation of endometrial thickness in the UK?

5mm (but I've also seen 3 in the notes and Peterborough said 4 so idk)

13

How is a definitive diagnosis of the cause of post-menopausal bleeding made?

Histology of biopsy

14

How are most endometrial biopsies obtained?

Pipelle method

15

What method of obtaining biopsies is preferred for endometrial polyps an other benign lesions?

Hysteroscopy and curretage

16

How can cervical polyps be treated?

Removal

17

How can endometrial atrophy be treated?

Oestrogen cream or pessaries

18

How can HRT related post-menopausal bleeding be stopped?

By stopping or changing HRT