What is the abnormal uterine bleeding?
Abnormal uterine bleeding is usually described by patients as vaginal bleeding, present in approximately 64-88% of women with some sort of uterine pathology. Post-menopausal bleeding (PMB) is the most common reason for the referral to the gynecological clinic within the two-week wait suspected cancer pathway.
In the United Kingdom, the average age for a woman to reach menopause is approximately 52 years. PMB is defined as vaginal bleeding in postmenopausal (PM) women that occurs at least 1 year after their last menstrual period in women, not on hormonal replacement therapy (HRT). Bleeding after this time in PM women is then classified as an abnormal PMB. The cause of PMB can be associated with either endometrial degeneration, endometrial polyps, submucosal fibroids, endometrial hyperplasia, and endometrial carcinoma.
The endometrium reveals a wide spectrum of normal and compulsive appearances throughout menarche as well as prepubertal and PM years. The normal appearances of the PM examination should consider the patient’s clinical history and whether they have undergone HRT. When assessing the endometrium in a normal PM patient the appearance is demonstrated as thin, homogenous and echogenic.