Postmenopausal bleeding: a practical approach.

Abstract

PURPOSE: To provide nurse practitioners (NPs) with a practical approach for the management of postmenopausal bleeding in office settings. DATA SOURCES: Selected scientific literature and the author's own experience. CONCLUSIONS: Postmenopausal bleeding should be considered cancer until proven otherwise, despite the fact that abnormal pathology is found in only 15% of endometrial biopsies. IMPLICATIONS FOR PRACTICE: Post menopausal bleeding can be safely evaluated and managed by NPs using aspiration endometrial biopsies and/or transvaginal ultrasound. Hospitalization for dilation and curettage under anaesthesia can often be avoided.