[Examination and treatment of gynecological bleeding disorders]

The investigation and treatment of gynaecological dysfunctional bleeding has remained largely unchanged since the problem was dealt with in a special issue of the Journal of the Norwegian Medical Association in 1976, in spite of the advent of modalities like endometrial cytology, hysteroscopy and vaginal ultrasonography, as well as knowledge about the relative lack of efficiency of dilatation and curettage in the investigation and treatment of the condition. We describe a modern programme for investigation and treatment of gynaecological dysfunctional bleeding. The programme relies on clinical assessment combined with medical therapy, with optional use of modern investigative modalities when indicated. In a strictly controlled outpatient programme the need for dilatation and curettage can be greatly reduced without jeopardizing the safety of the patient.