Abnormal vaginal bleeding

Question 1

Normal endometrial thickness of

• pre-menapausal woman
• peri-menapausal woman
• post menopausa woman

Answer 1

pre menopausal < or equal to 12mm
peri menopausal < or equal to 5mm
post menopausa < or equal to 4mm

Question 2

In pre-menopausal woman when is the most accurate to do a pelvic U/S for endometrial thickness?

Answer 2

performed on days 4-7 of cycle when messes has ceased

Question 3

What’s the definition of peri menopause?

Answer 3

the average length is 5 years

FSH and oestradiol oscillates frequently with decreasing luteal function

Question 4

Definition of a post menopausal bleed

Answer 4

PV bleed that occurs more than one year after the last bleed

Question 5

What are the causes of a post menopausal bleed?

(Ref: Office Gynaecology Dr Adele Zito
RANZCOG Trainee)

Answer 5

Atrophy (vaginal, endometrial & urogenital) 60-80% 
Exogenous Oestrogen (15-25%)
Cervical/Endometrial Polyps (2-12%)
Endometrial Hyperplasia (10%)
Endometrial Cancer (10%)
Cervical Cancer <1%

Question 6

Definition of Endometrial Hyperplasia.
What is Endometrial Hyperplasia a risk factor for?

(Ref: Office Gynaecology Dr Adele Zito
RANZCOG Trainee)

Answer 6

Proliferation of the endometrial glands which increases glands:stoma ratio.

Increases risk of endometrial cancer