Diagnosis of postmenopausal bleeding begins with the patient. The doctor will ask for a detailed history of how long postmenopausal bleeding has occurred. A woman can assist the doctor by keeping a record of the time, frequency, length, and quantity of bleeding. She should also tell the doctor about any medications she is taking, especially any estrogens or steroids.
After taking the woman's history, the doctor does a pelvic examination and PAP test. The doctor will examine the vulva and vagina for any signs of atrophy, and will feel for any sign of uterine polyps. Depending on the results of this examination, the doctor may want to do more extensive testing.
Invasive diagnostic procedures
Endometrial biopsy allows the doctor to sample small areas of the uterine lining, while cervical biopsy allows the cervix to be sampled. Tissues are then examined for any abnormalities. This is a simple office procedure.
Dilatation and curettage (D & C) is often necessary for definitive diagnosis. This is done under either general or local anesthesia. After examining the tissues collected by an endometrial biopsy or D & C, the doctor may order additional tests to determine if an estrogensecreting tumor is present on the ovaries or in another part of the body.
Tish Davidson, The Gale Group Inc., Gale, Detroit,