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Postmenopausal bleeding: a practical approach.

H F McGregor1

  • 1Regional Breast Cancer Program, Madigan Army Medical Center, Tacoma, WA, USA. Helen.McGregor@nw.amedd.army.mil

Journal of the American Academy of Nurse Practitioners
|April 5, 2002
PubMed
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Nurse practitioners (NPs) can effectively manage postmenopausal bleeding in office settings. Utilizing aspiration endometrial biopsies and transvaginal ultrasound allows for safe evaluation, often avoiding hospitalization for dilation and curettage.

Area of Science:

  • Gynecology
  • Primary Care Medicine

Background:

  • Postmenopausal bleeding (PMB) is a common gynecological concern.
  • While often benign, PMB necessitates thorough investigation due to the potential for malignancy.

Purpose of the Study:

  • To equip nurse practitioners (NPs) with a practical, office-based management strategy for postmenopausal bleeding.
  • To outline an evidence-based approach for the initial evaluation of PMB.

Main Methods:

  • Review of selected scientific literature.
  • Incorporation of the author's clinical experience in managing PMB.

Main Results:

  • Postmenopausal bleeding requires a high index of suspicion for malignancy, even when initial biopsies are negative.
  • Abnormal pathology is identified in approximately 15% of endometrial biopsies for PMB.

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Conclusions:

  • Nurse practitioners can safely and effectively manage postmenopausal bleeding in an outpatient setting.
  • Aspiration endometrial biopsies and transvaginal ultrasound are key diagnostic tools for NPs.
  • This approach can reduce the need for invasive procedures like dilation and curettage under anesthesia.