|NEWSRoom | Source: The Society of Radiologists in Ultrasound (SRU)|
Physicians Meet to Develop Consensus Guidelines for Bleeding After Menopause
Bleeding after menopause is associated with an increased risk of uterine cancer, the most common gynecologic cancer. The diagnosis of uterine cancer is commonly found because of abnormal vaginal bleeding after menopause. This can occur in patients undergoing hormone replacement therapy or in those not taking hormones. In the past, all women with bleeding underwent biopsy of the uterine lining. A consensus panel of gynecologists, radiologists, oncologists and a pathologist, sponsored by the Society of Radiologists in Ultrasound, met in Washington, DC to discuss this common and important problem. Approximately 25 physicians and representatives of government agencies attended the meeting.
The panel concluded that one of two tests must be performed in any patient with abnormal bleeding after menopause: a sonogram performed by insertion of the ultrasound probe into the vagina (known as transvaginal sonography) or a biopsy of the uterine lining. Both methods can detect uterine cancer well. Another test, a relatively new procedure, during which transvaginal ultrasound is used while fluid is infused into the uterine cavity, can also be used to detect causes of abnormal bleeding. This test, known as saline infusion sonohysterography, is less invasive and less expensive than surgical procedures such as hysteroscopy and is often useful when the transvaginal sonogram or biopsy is inconclusive.
A statement describing the consensus of the panel and participants will be formally published in a medical journal. The conference also resulted in several important topics for potential research projects including the cost effectiveness of beginning the evaluation of this subset of women with ultrasound vs. biopsy and the importance of finding benign causes of bleeding after menopause and the effect of this on quality of life.
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