Peri- and Postmenopausal Abnormal Bleeding

In: Clinical Perspectives in Obstetrics and Gynecology · 1994 · pp. 229–245 · doi:10.1007/978-1-4612-4330-4_23 · W332415659
book-chapter OA: closed CC0
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06+body, 2026-06-12

This paper discusses peri- and postmenopausal abnormal bleeding, defining the condition, and reviewing its physiopathology, differential diagnosis, investigation, and treatment.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text

This chapter reviews peri- and postmenopausal abnormal uterine bleeding, describing definitions, physiopathology, differential diagnosis, investigation strategies, and treatment approaches, with a brief overview of the relative potency of different progestogens. It synthesizes the existing clinical literature rather than reporting original study data, and the included references span topics such as endometrial assessment (e.g., ultrasound, histology, hysteroscopy) and hormone-related bleeding patterns. A stated caveat is that the text is a clinical “chapter” that depends on prior evidence and presents a broad framework, without providing a single new dataset or trial outcome. Relevance to endometriosis: the chapter cites adenomyosis as a related uterine disorder in the context of abnormal bleeding and uterine pathology (e.g., via an “Adenomyosis: current perspectives” reference), even though its main focus is peri- and postmenopausal abnormal bleeding generally rather than endometriosis or adenomyosis specifically.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 9,101 characters · extracted from oa-doi-fallback · 3 sections · click to expand

Abstract

The climacteric is a period during which women experience many new symptoms. One of the most important clinically is a modification in the pattern of menses. In this chapter, we focus on peri- and postmenopausal abnormal bleeding. Definitions are given and physiopathology, differential diagnosis, investigation, and treatment are discussed. A brief review of the potency of the different progestogens is also provided. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

Reference

Christopher Nordin BE, Morris HA, Need AG, Horowitz M, Robertson WG. Relationship between plasma calcium fraction other bone related variables, and serum follicle-stimulating hormone levels in premenopausal, perimenopausal, and postmenopausal women. Am J Obst Gynecol. 1990; 163: 140–145. 15. Tsonis CB, Messinis IE, Templeton AA, McNeilly AS, Baird DT. Conadotropic stimulation of inhibin secretion by the human ovary during the follicular and early luteal phase of the cycle. J Clin Endocrinol Metab. 1988; 66: 16. 915–921. Koutsilieris M, Michaud J, Nikolis, A. Preferential mitogenic activity for myoblast-like cells can be extracted from uterine leiomyoma 17. tissues. Am J Obste Gynecol. 1990: 163: 1665 1670. Azziz R. Adenomyosis: current perspectives. Obstet Gynecol Clin Am. 1990;16(1):221235. Urabe M, Yamamoto T, Ktawaki J, Honjo H, Okada H. Estrogen biosynthesis in human 19. uterine adenomyosis. Acta Endocrin. 1989; 121 (2): 259–264. Robbins S, Cotron RD, Kumarv. Pathologic 20. Basis of Disease. Philadelphia: WB Saunders; 1984: 1135–1136. Corley D, et al. Post menopausal bleeding from unusual endometrial polyps in woman and chronic tamoxifen therapy. Obstet Gynecol. 1992; 79 (1): 111. Bemtrac MBB, Warren T, Kable MD, Gallagher JC. Histology and bleeding patterns in menopausal women treated with estrogen and continuous or cyclic progestin. J Repro Med. 1988; 33 (2): 205. Maheux R, Lemay A. Treatment of perimenopausal women: potential long term therapy with a depot GnRh agonist combined with hormonal replacement therapy. Br J Obs Gyn. 1992; 99: 7. Montemagno U, De Placido G, Colacurci N, et al. Endometrial effects of danazol in perimenopausal abnormal bleeding. Ann NY Acad S c i. 1991; 622: 283–290. Marion A, Van Ejikeren, Godelieve CML, et al. Effects of Mefanic acid on menstrual hemostasis in essential menorrhagia. Am J Obste Gynecol. 1992; 166 (5): 1419–1428. Gannon M, et al. A randomized trial comparing endometrial resection and abdominal hysterectomy for the treatment of menorrhagia. BMJ. 1991; 303: 1362–1364. Derman S, et al. The long term effectiveness of hysteroscopic treatment of menorrhagia and leiomyomas. Obstet Gynecol. 1991; 77: 591–594. Jacobs I, Oram D. Prevention of ovarian cancer: a survey of the prophylactic oophorectomy by fellows and members of the Royal College of Obstetricians and Gynecologist. Br J Obstet Gynecol 1989; 96: 510. Speroff T, Dawson N, Speroff L, Haber, RJ. A risk-benefit analysis of elective bilateral oophorectomy; effect of changer in compliance with estrogen therapy on outcome. Am J Obst Gynecol. 1991; 164: 165–74. Kerlikowke K, Brown JS, Grady DG. Should women with familial ovarian cancer undergo prophylactic oophorectomy? Am J Obstet Gynecol. 1992; 80 (4): 700–707. Whitehead M, Godfree V. Hormone replacement therapy, your questions answered. Churchill Livingston. 1992: 172. Hill G, et al. Comparison of late luteal phase endometrial biopsies using the Novak curette or Pipelle endometrial suction curette. Obstet Gynecol. 1989; 73: 443–445. Archer DF, et al. Endometrial morphology in asymptomatic postmenopausal women. Am J Obstet Gynocol. 1991; 165: 317–322. Paganini-Hill A, et al. Endometrial cancer and patterns of use of oestrogen replacement: a cohort study Br J Cancer. 1989; 59: 445–447. Leather AT, et al. Endometrial histology bleeding patterns after 8 years of continuous combined estrogen and progestogen therapy in postmenopausal women. Obstet Gynecol. 1991; 78: 1008–1010. Bunin N, et al. Endometrial adenocarcinoma in breast cancer patients receiving antiestrogens. Cancer Treat Rep. 1985; 69: 237–238. Fornander T, et al. Adjuvant Tamakifen in early breast cancer: occurence of new primary cancers. Lancet. 1989; 117–120. Lin M, et al. Endometrial thickness after menopause: effect of hormone replacement. Radiology. 1991; 180: 427–432. Granberg S, et al. Endometrial thickness as measured by endovaginal ultrasonography for identifying endometrial abnormality. Am J Obstet Gynecol. 1991; 164: 47–52. Nasri MN, Coast GJ. Correlation of ultra-sound findings and endometrial histopathology in postmenauposal women. Br J Obst Gynecol 1989; 96: 1333–1338. Grunfeld L, et al. High-resolution endovaginal ultrasonography of the endometrium: a noninvasive test for endometrial adequacy. Obstet Gynecol. 1991; 78: 200–204. Osmers R, et al. Vaginosonograophy for early detection of endometrial carcinoma? Lancet. 1990; 335: 1569–1571. Parlson J, Anger PMD, Thomson S, Carlson EJ. Clinical and Pathologic correlation of endometrial cavity fluid detected by ultra-sound in the postmenopausal patient. Obstet Gynecol. 1991; 77: 119. Scoutt LM, McCarthy SM. Applications of magnetic resonance imaging to gynecology. Topics MRI. 1990; 2 (3): 37–49. Loffer F Hysteroscopy with selective endometrial sampling compared with D & C for abnormal uterine bleeding: the value of a negative hysteroscopic view. Obstet Gynecol. 1989;73:16–20. Bryjalsen I, et al. The measurement of secretory endometrial protein PP14 in serum from postmenopausal women receiving unopposed estrogen or continuously combined estrogen/ progestogen. Gynecol Endocrin. 1989; 3: 143–152 Bryjalsen I, et al. Sequential estrogen and progestogen therapy assessment of progestational effects on the postmenopausal endometrium. Obstet Gynecol. 1992; 79: 523–528. Tin-Chiu L, et al. An analysis of the variation of plasma concentrations of placental protein 14 on artificial cycles. Fertil Steril, 1992; 57: 776–787. Gambrel RD, et al. Use of the progestogen challenge test to reduce the risk of endometrial cancer. Obstet Gynecol. 1980; 55: 732–738. Hargrove, et al. Menopausal hormone replacement therapy with continuous daily micronized estradiol and progesterone. Obstet Gynecol. 1979; 73: 606–612. Mattsson LA, et al. Evaluation of a continuous oestrogen progestogen, regimen for climacteric complaints. Maturitas. 81; 3: 145–156. Weinstein, L. Efficacy of a continuous estrogen-progestin regimen in the menopausal patient. Obstet Gynecol. 87; 69: 929–932. Hargrove J, et al. Menopausal hormone replacement therapy with continuous daily and micronized estdradiol and progesterone. Obstet Gynecol. 1989; 73: 606–612. King R, Whitehead M. Assessment of the potency of orally administered progestins in women. Fertil Steril. 1986; 46: 1062–1066. Kauppila A, et al. Postmenopausal hormone replacement therapy with estrogen periodically supplemented with antiestrogen. Am J Obstet Gynecol. 1981; 140: 787–792. Marslew U. Bleeding pattern during continuous-combined estrogen-progesterone therapy. Am J Obstet Gyneol. 91; 164: 1163–1168. Gordon MG, Williams SR, Frenchek B, et al. Dose-dependent effects of postmenopausal estrogen/progestin on antithrombin III and factor XII. J Lab Clin Med. 1988; 111: 52. Krailo MD, Pike MC. Estimation of the distribution of age of natural menopause from prevalence data. Am J Epidemiol. 1983; 117: 356. Melis GB, Fruzzetti F, Nicoletti I, et al. A comparative study on the effects of a monophasic pill containing desogestrel plus 20 ug ethinylestradiol, a triphasic combination containing levonorgestrel and a monophasic combination containing gestodene on coagulatory factors. Contraception. 1991; 43: 23. Stampfer MJ, Wilett WC, Colditz GA, et al. Past use of oral contraceptives and cardiovascular disease: A meta-analysis in the context of the nurse’s health study. Am J Obstet Gynecol. 1990; 163: 285. Chen KTK, Schooley JL, et al. Peritoneal carcinomatosis after prophylactic oophorectomy in familial ovarian cancer syndrome. Obstet Gynecol. 1985; 665: 93–94. Kerlikowske K, Brown JS, et al. Should women with familial ovarian cancer undergo prophylactic oophorectomy? Obstet Gynecol. 1992; 80: 700–707. Editor information Editors and Affiliations Rights and permissions Copyright information © 1994 Springer-Verlag New York, Inc. About this chapter Cite this chapter Lorrain, J., Ravnikar, V.A., Charest, N. (1994). Peri- and Postmenopausal Abnormal Bleeding. In: Lorrain, J., Plouffe, L., Ravnikar, V.A., Speroff, L., Watts, N.B. (eds) Comprehensive Management of Menopause. Clinical Perspectives in Obstetrics and Gynecology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4330-4_23 Download citation DOI: https://doi.org/10.1007/978-1-4612-4330-4_23 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4612-8737-7 Online ISBN: 978-1-4612-4330-4 eBook Packages: Springer Book Archive

Keywords

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (48)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK