A 52 year old post menopausal woman presents with vaginal bleeding for 3 weeks. She is worried whether this could be a cancer similar to her sister. Transvaginal ultrasound reveals an endometrial thickness of 8.0 mm. The next step in the management should be:
The patient has presented with post-menopausal bleeding and her ultrasonogram has revealed a endometrial thickness of 8 mm and has clearly ruled out the presence of polyps (which might also cause vaginal bleeding in a post menopausal woman). Endometrial thickness upto 5 mm is considered as normal in a post menopausal woman. But with a 8 mm thickness, the next best step would be to do a histo-pathological examination of the endometrium obtained from a curettage. Ref: Clinical Gynaecology By T. F. Kruger, M. H. Botha, Pages 498-501
Hysterectomy
Sta Progesterone Therapy
Histopathological Examination of curettage
Observe and Follow Up