Abnormal uterine bleeding in women is a common cause for gynecologic consultation. Physicians must maintain a low threshold for endometrial assessment in abnormal uterine bleeding. Accurately determining the etiology of the bleeding permits appropriate treatment, minimizes unnecessary delays in therapy, and prevents needless worry in women. There are few national consensus guidelines, best practice guidelines, or treatment algorithms that provide gynecologists with scrupulous data to make concise decisions for the utilization of technology such as endometrial biopsy, transvaginal ultrasound, saline infusion sonography, or hysteroscopy in the evaluation of menstrual aberrations. Using technology that has a high sensitivity to detect a disease allows a physician to make concise decisions for proceeding with minimally invasive procedures or reliance on medical therapies that will probably be effective.
From the Center for Menstrual Disorders, Fibroids, and Hysteroscopic Services, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH.
Received September 8, 2010; revised and accepted January 25, 2011.
Funding/support: None reported.
Financial disclosure/conflict of interest: The author is a member of the Speakers Bureau for Teva, Bayer, Merit Medical, and Ferring. She is also aconsultant for Bayer, Merit Medical, Gyrus ACMI, and Ferring. Royalties: Up-to-date and for textbook Hysteroscopy: Office Evaluation and Management of the Uterine Cavity, Bradley LD, Falcone T (eds.), 2009, Mosby Elsevier.
Presented at the Premeeting Symposium: "Abnormal Uterine Bleeding: Causality, Diagnosis & Management"; October 6, 2010.
Address correspondence to: Linda D. Bradley, MD, Center for Menstrual Disorders, Fibroids, and Hysteroscopic Services, Department of Obstetrics and Gynecology, Cleveland Clinic, 9500 Euclid Avenue, Desk A 81, Cleveland, OH 44195. E-mail: firstname.lastname@example.org