assessment of post menopausal bleeding
General points are listed below:
- last menstrual period?
- like a period?
- associated with intercourse?
- previous episodes?
- vaginal discharge
- any features suggestive of infection?
- last cervical smear
- drug history
- on HRT that is not designed to have cyclical bleeding?
- previous use of oral contraceptive pill?
- obstetric history
- nulliparity associated with endometrial carcinoma
- functional enquiry - any recent unexplained weight loss, loss of appetite
- abdominal examination
- speculum examination - smears if indicated from history or examination
- vaginal examination - assessment of uterus size and consistency
- in general a hysteroscopy is indicated
Last reviewed 01/2018