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Abstract
Peri and postmenopausal bleeding is a common clinical problem. The exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with abnormal uterine bleeding.
Abnormal uterine bleeding can take many forms, and pinpointing the cause can be a challenge, as it ranges from some emotional upset up to malignancy. Although cancer is not the most common etiology of abnormal uterine bleeding (especially in perimenopausal women), it is the most important.
As a common clinical problem with myriad causes, physicians must have solid knowledge of menstrual physiology and an approach to differential diagnosis to evaluate and manage the problem with confidence.
Many women referred for gynecologic examination do not return for recommended biopsy when the initial evaluation suggests possible endometrial lesions.
Endometrial biopsy and tissue examination is considered an important diagnostic tool for the evaluation of abnormal uterine bleeding. The documented safety and accuracy of plastic endometrial sampling devices have made them popular for use in the office.