Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause

Lil Valentin, L. Valentin
Best practice & research. Clinical obstetrics & gynaecology · 2014 · vol. 28(5) , pp. 637–654 · doi:10.1016/j.bpobgyn.2014.04.001 · PMID:24834911 · W2167128145
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⚙ AI-generated summary by gemini-2.5-flash-lite+body, 2026-06-07 ⓘ

Transvaginal ultrasound is key for managing abnormal vaginal bleeding in non-pregnant women, triaging postmenopausal bleeding risk for endometrial cancer and offering some utility before menopause.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This chapter reviews how imaging—especially transvaginal ultrasound—is used to manage abnormal vaginal bleeding in non-pregnant women before and after menopause, focusing on ultrasound findings across several uterine conditions. It states that no other imaging technique has a role in triaging these women, and that in postmenopausal bleeding ultrasound helps categorize patients into low- or high-risk groups for endometrial cancer, forming the basis for further management. For premenopausal bleeding, it notes that ultrasound’s role is less clear because several common causes (such as infection, dysfunctional bleeding, or issues related to intrauterine contraceptive devices or pills) cannot be diagnosed with ultrasound. It includes adenomyosis among the ultrasound conditions discussed, but it does not present a new study population or original data—so the explicit limitation is that this is a review/chapter rather than comparative evidence. This paper is centrally about endometriosis—specifically, it discusses adenomyosis as an ultrasound finding within abnormal vaginal bleeding management, which is closely related to the endometriosis spectrum.

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Abstract

Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may also sometimes be helpful in women with abnormal vaginal bleeding before the menopause. In this chapter, I present ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas, including submucous myomas and leiomyosarcoma, and describe ultrasound-based triage of women with postmenopausal bleeding.
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Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause. (2014) In Best Practice and Research: Clinical Obstetrics Gynaecology 28(5). p.637-654- Abstract - Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless,... (More) - Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may also sometimes be helpful in women with abnormal vaginal bleeding before the menopause. In this chapter, I present ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas, including submucous myomas and leiomyosarcoma, and describe ultrasound-based triage of women with postmenopausal bleeding. (Less) Links Related Resources Scopus publication: Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/4454450 - author - Valentin, Lil LU - organization - publishing date - 2014 - type - Contribution to journal - publication status - published - subject - in - Best Practice and Research: Clinical Obstetrics Gynaecology - volume - 28 - issue - 5 - pages - 637 - 654 - publisher - Bailliere Tindall Ltd - external identifiers - - pmid:24834911 - wos:000338390400003 - scopus:84902295445 - pmid:24834911 - ISSN - 1878-156X - DOI - 10.1016/j.bpobgyn.2014.04.001 - language - English - LU publication? - yes - id - b2969d35-5296-4f7c-896b-7ad292a29e95 (old id 4454450) - alternative location - http://www.ncbi.nlm.nih.gov/pubmed/24834911?dopt=Abstract - date added to LUP - 2016-04-01 10:09:44 - date last changed - 2025-10-14 11:33:00 @article{b2969d35-5296-4f7c-896b-7ad292a29e95, abstract = {{Transvaginal ultrasound plays a pivotal role in the management of non-pregnant women with abnormal vaginal bleeding. No other imaging technique has a role in the triage of these women. In women with postmenopausal bleeding, ultrasound is used to categorise women as at low or high risk of endometrial cancer, and the result of the ultrasound examination is the basis for further management. In women with abnormal vaginal bleeding before the menopause, the role of ultrasound is less clear. This is because some common causes of abnormal vaginal bleeding before the menopause cannot be diagnosed with ultrasound, such as infection, dysfunctional bleeding, or problems with intrauterine contraceptive devices or contraceptive pills. Nonetheless, transvaginal ultrasound may also sometimes be helpful in women with abnormal vaginal bleeding before the menopause. In this chapter, I present ultrasound findings in women with endometrial cancer, endometrial polyps, endometrial hyperplasia, adenomyosis, uterine myomas, including submucous myomas and leiomyosarcoma, and describe ultrasound-based triage of women with postmenopausal bleeding.}}, author = {{Valentin, Lil}}, issn = {{1878-156X}}, language = {{eng}}, number = {{5}}, pages = {{637--654}}, publisher = {{Bailliere Tindall Ltd}}, series = {{Best Practice and Research: Clinical Obstetrics Gynaecology}}, title = {{Imaging techniques in the management of abnormal vaginal bleeding in non-pregnant women before and after menopause.}}, url = {{https://lup.lub.lu.se/search/files/1615963/5052734.pdf}}, doi = {{10.1016/j.bpobgyn.2014.04.001}}, volume = {{28}}, year = {{2014}}, }

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MeSH descriptors

Uterine Hemorrhage Endometrial Hyperplasia Endometrial Hyperplasia Endometrium Endometrium Female Humans Leiomyoma Leiomyoma Physical Examination Polyps Polyps Postmenopause Premenopause Triage Ultrasonography Urinary Bladder Neoplasms Urinary Bladder Neoplasms Uterine Hemorrhage Uterine Neoplasms

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