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November 4, 1998

Vaginal Ultrasonography to Evaluate Postmenopausal Bleeding

Author Affiliations

From the Medical Service and Vincent Obstetrics and Gynecology Service, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass.

JAMA. 1998;280(17):1529-1530. doi:10.1001/jama.280.17.1529

Even before the era of hormone replacement therapy, postmenopausal vaginal bleeding was a common problem. But now, increasing use of hormone replacement therapy (HRT) has made abnormal bleeding an even more frequent reason for office visits. Current guidelines from the American College of Obstetricians and Gynecologists recommend endometrial biopsy for women who are taking continuous combined HRT and have bleeding for more than 6 months after starting treatment, and for any prolonged or irregular bleeding in women taking cyclic HRT. About 20% of postmenopausal women taking continuous combined HRT still have bleeding at 12 months; variations in bleeding patterns in women taking cyclic HRT are common.1 Thus, a substantial number of postmenopausal women will face the prospect of diagnostic testing to evaluate abnormal vaginal bleeding.