title: Menorrhagia and abnormal bleeding before the menopause.
abstract: Abnormal uterine bleeding before the menopause accounts for 20% of visits to the gynaecology clinic and almost 25% of gynaecological operations. The patient who presents with such bleeding presents two distinct but important challenges for the clinician. The first is the exclusion of cancer or hyperplasia; the second is dealing with the annoyance as well as the fear that the bleeding engenders in the patient. Any attempt at appropriate therapy--whether surgical, hormonal or expectant--begins with an accurate diagnosis. Transvaginal ultrasound with saline infusion sonohysterography for selective patients has emerged as a safe, non-invasive and, inexpensive method of triaging patients with abnormal uterine bleeding in order to determine which patients require no further evaluation, blind endometrial sampling for a global endometrial process or visually directed endometrial sampling when pathology is thought to be focal.
authors.affiliation: Department of Obstetrics and Gynecology, New York University Medical Center, School of Medicine, 530 First Avenue, Suite 10N, New York, NY 10016, USA. steven.goldstein@med.nyu.edu
authors.forename: Steven R
authors.initials: SR
authors.lastname: Goldstein
mesh_terms: D001706:Biopsy; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000000981:diagnostic imaging / Q000209:etiology; D017697:Premenopause; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology*