Abnormal Bleeding

Over the age of 40 and for high-risk patients (polycystic ovarian disease, patients with obesity and hypertension, and anovulation) over the age of 35, all patients with abnormal bleeding should have endometrial sampling.

Also there are more common occurrences of mechanical bleeding; such as endometrial polyps or uterine fibroids in this age category. Abnormal uterine bleeding would be defined as any menstrual bleeding longer than 7 days and any period less than 23 days apart. Volume of flow also may be abnormal but it is very difficult to measure. History alone is not always accurate.

Any abnormal bleeding over the age of 40 or over the age of 35 in high risk patients should be primarily investigated by evaluation for mechanical causes or cancer.