Pe Perimenopausal ir irregular lar ble leedin ing Associated - - PowerPoint PPT Presentation

6/4/18 114 16th WCM Pre-Congress Workshop

Pe Perimenopausal ir irregular lar ble leedin ing

• Associated with anovulation but precise mechanisms unclear.
• Will affect 50% of perimenopausal women and is to some extent‘normal’
• Mostly due to dysfunctional bleeding
• 2-14% of endometrial cancers occur in premenopausal women
• Concurrent ovarian malignancy is more common
• May be associated with intrauterine pathology
• submucous myomas (14%)
• endometrial polyps (14%)

6/4/18 115 16th WCM Pre-Congress Workshop

In Inves estigation of AUB B

• Menstrual history – bleeding patterns, pain, clots,
• Medical and surgical history
• Medications
• History of haemostatic disorders
• Examination: general and pelvic – Look!
• Lab tests: FBC, ferritin, TSH, HCG, Bleeding disorders (when indicated)
• Transvaginal ultrasound,
• Saline infusion sonography,
• Office endometrial sampling
• Hysteroscopy and biopsy

6/4/18 116 16th WCM Pre-Congress Workshop

No Norma mal en endome metr trium

Secretory endometrium Proliferative endometrium

6/4/18 117 16th WCM Pre-Congress Workshop

Endo Endometri rial hype perpl rplasia

6/4/18 118 16th WCM Pre-Congress Workshop

Endo Endometri rial Polyp