The incidence of postmenopausal bleeding varies from 1.7- 14.6 per 1000 women, depending on age. The chance to find an endometrial carincoma in women with postmenopausal bleeding varies between 1% and 24%, and is also dependent on age.1 While the incidence of bleeding decreases with age, the chance of finding a carcinoma increases with age.l In women with postmenopausal bleeding a transvaginal ultrasound can be made to exclude uterine causes of the bleeding. Using a cut-off value for endometrial thickness (measured as a double layer) of 4 mm shows a sensitivity of 92% and specificity of 92% for all endometrial pathology, and a sensitivity of 96% for endometrial carincoma.Premalignant and malignant disorders of the endometrium are found in about 12% of the patients with postmenopausal bleeding, regardless of the endometrium thickness. In women with postmenopausal bleeding and an endometrium thickness of 5 mm or more in 41% an endometrial polyp was found.
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