Perimenopausal bleeding patterns and pathologic findings.
The charts of 500 sequential perimenopausal patients were reviewed and their alterations in menstrual flow were characterized as fitting one of three patterns. Sixty-two patients (12%) had sudden amenorrhea, 347 (70%) had oligomenorrhea and/or hypomenorrhea, and 91 (18%) had menorrhagia, metrorrhagia, and/or hypermenorrhea. All of the patients in the menorrhagia/metrorrhagia and/or hypermenorrhea group had histologic evaluations to rule out the presence of premalignant or malignant disease; 17 women (19%) in this group had premalignant or malignant findings. In addition, 4 of the 5 women with malignancies had intermenstrual bleeding. Of the 9 women in the study with intermenstrual bleeding, 4 had invasive cancer and 2 had endometrial hyperplasia. This study documents and highlights the high incidence of premalignant and malignant findings in perimenopausal patients with bleeding patterns other than amenorrhea or oligomenorrhea/hypomenorrhea, and underscores the need for perimenopausal women with menorrhagia, metrorrhagia, and/or hypermenorrhea to undergo thorough evaluation.
Queens Hospital Center Affiliation, Long Island Jewish Medical Center in Jamaica, New York.
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Seltzer
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Benjamin
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Deutsch
D000367:Age Factors; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008597:Menstrual Cycle / Q000502:physiology*; D008598:Menstruation / Q000502:physiology*; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies