Clinical Case Database / Category: Patient Management

Post Menopausal Bleeding

Publication details

Mrs Malini Prasad MBBS, MD, MRCOG, MA (Med. Edu.), Dr M Dada
Foundation Years Journal, volume 8, issue 9, p.58 (123Doc Education, London, October 2014)


This discussion is based on the diagnostic pathway of a fifty seven year old woman who presented to her GP with postmenopausal bleeding. The learning objectives would be to explain the rationale for the different investigations and her management.

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Mrs Malini Prasad MBBS, MD, MRCOG, MA (Med. Edu.)

Consultant Obstetrics and Gynaecology
Department of Obstetrics and Gynaecology
West Suffolk Hospital, Hardwick Lane
Bury, St Edmunds, IP33 2QZ

Dr M Dada

Consultant Histopathologist
West Suffolk Hospital, Hardwick Lane
Bury, St Edmunds, IP33 2QZ


1. Astrup, K & Olivarius, NDF 2004, 'Frequency of spontaneously occurring postmenopausal bleeding in the general population' Acta Obstetricia et Gynecologica Scandinavica, 83:203-207.
2. Scottish Intercollegiate Guidelines Network 2002. Investigation of Post-Menopausal Bleeding
3. Clinical Practice guideline Royal college of physicians of Ireland 2013. Investigation of postmenopausal bleeding.
4. Zeleniuch-Jacquotte A, Akhmedkhanov A, Kato I, et al 2001. Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study. Br J Cancer 84 (7): 975-81.
5. National Institute for Health and Clinical Excellence interventional Procedure Guidance 356 (2010) Laparoscopic hysterectomy (including laparoscopic total hysterectomy and laparoscopically assisted vaginal hysterectomy) for endometrial cancer.
6. Morgan-Ortiz F, Soto-Pineda JM et al 2013. Effect of body mass index on clinical outcomes of patients undergoing total laparoscopic hysterectomy. Int J of Gynecol & Obstet 120(1): 61-64.
7. WHO 1996. Research on the Menopause in the 1990s Report of a WHO Scientific Group. World Health Organisation, WHO Technical Report Series No. 866.
8. Cancer research 2014. Cancer statistics endometrium.
9. MedGyn endosampler.
10. National Institute for Health and Care Excellence. Referral Guidelines for suspected cancer.
11. Tandulwadkar S, Deshmukh P, Lodha P et al 2009. Hysteroscopy in Postmenopausal Bleeding. J Gynecol Endosc Surg. 1(2): 89â€"93.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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