What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?

H. C. Van Doorn, A. Timmermans, B. C. Opmeer, R. F M P Kruitwagen, F. P H L J Dijkhuizen, G. S. Kooi, P. H M Van De Weijer, B. W J Mol

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective. To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness ≤4 mm after a first episode of postmenopausal bleeding. Methods. Consecutive patients not using hormone replacement therapy (HRT) presenting with a first episode of postmenopausal bleeding and an endometrial thickness ≤4 mm at transvaginal ultrasonography (TVU) were managed expectantly. In case of recurrent bleeding, the patient was evaluated according to the hospital's local policy with TVU, office endometrial sampling, hysteroscopy or dilatation and curettage (D&C) or a combination of these tests. We evaluated the incidence of recurrent bleeding, potential risk factors for recurrent bleeding, and the diagnosis made after recurrent bleeding. Results. A total of 607 patients were registered with a first episode of postmenopausal bleeding, of whom 249 had an endometrial thickness ≤4 mm. Follow-up took place with a median of 174 weeks (range: 4-250 weeks). During follow-up, 25 of the 249 patients (10%; 95% CI: 6.6-14%) had recurrent bleeding. Median time until recurrence of bleeding was 49 weeks (range: 9-186 weeks). Two patients with recurrent bleeding turned out to have an endometrial carcinoma (8%; 95% CI: 2.2-25%), and 1 patient had a malignant melanoma. Time since menopause, age, body mass index, hypertension, diabetes and anticoagulants were not predictive for recurrent bleeding. Conclusion. The recurrence rate after a first episode of postmenopausal bleeding managed expectantly is low and cannot be predicted by patient characteristics. Patients with recurrent bleeding should be re-evaluated, as they bear a considerable risk of carcinoma.

LanguageEnglish
Pages89-93
Number of pages5
JournalActa Obstetricia et Gynecologica Scandinavica
Volume87
Issue number1
DOIs
Publication statusPublished - 2008

Keywords

  • Endometrial thickness ≤4 mm
  • Postmenopausal bleeding
  • Recurrence rate

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Van Doorn, H. C., Timmermans, A., Opmeer, B. C., Kruitwagen, R. F. M. P., Dijkhuizen, F. P. H. L. J., Kooi, G. S., ... Mol, B. W. J. (2008). What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding? Acta Obstetricia et Gynecologica Scandinavica, 87(1), 89-93. https://doi.org/10.1080/00016340701763130
Van Doorn, H. C. ; Timmermans, A. ; Opmeer, B. C. ; Kruitwagen, R. F M P ; Dijkhuizen, F. P H L J ; Kooi, G. S. ; Van De Weijer, P. H M ; Mol, B. W J. / What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?. In: Acta Obstetricia et Gynecologica Scandinavica. 2008 ; Vol. 87, No. 1. pp. 89-93.
@article{143712557794407c8ca704ddc2d4cd01,
title = "What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?",
abstract = "Objective. To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness ≤4 mm after a first episode of postmenopausal bleeding. Methods. Consecutive patients not using hormone replacement therapy (HRT) presenting with a first episode of postmenopausal bleeding and an endometrial thickness ≤4 mm at transvaginal ultrasonography (TVU) were managed expectantly. In case of recurrent bleeding, the patient was evaluated according to the hospital's local policy with TVU, office endometrial sampling, hysteroscopy or dilatation and curettage (D&C) or a combination of these tests. We evaluated the incidence of recurrent bleeding, potential risk factors for recurrent bleeding, and the diagnosis made after recurrent bleeding. Results. A total of 607 patients were registered with a first episode of postmenopausal bleeding, of whom 249 had an endometrial thickness ≤4 mm. Follow-up took place with a median of 174 weeks (range: 4-250 weeks). During follow-up, 25 of the 249 patients (10{\%}; 95{\%} CI: 6.6-14{\%}) had recurrent bleeding. Median time until recurrence of bleeding was 49 weeks (range: 9-186 weeks). Two patients with recurrent bleeding turned out to have an endometrial carcinoma (8{\%}; 95{\%} CI: 2.2-25{\%}), and 1 patient had a malignant melanoma. Time since menopause, age, body mass index, hypertension, diabetes and anticoagulants were not predictive for recurrent bleeding. Conclusion. The recurrence rate after a first episode of postmenopausal bleeding managed expectantly is low and cannot be predicted by patient characteristics. Patients with recurrent bleeding should be re-evaluated, as they bear a considerable risk of carcinoma.",
keywords = "Endometrial thickness ≤4 mm, Postmenopausal bleeding, Recurrence rate",
author = "{Van Doorn}, {H. C.} and A. Timmermans and Opmeer, {B. C.} and Kruitwagen, {R. F M P} and Dijkhuizen, {F. P H L J} and Kooi, {G. S.} and {Van De Weijer}, {P. H M} and Mol, {B. W J}",
year = "2008",
doi = "10.1080/00016340701763130",
language = "English",
volume = "87",
pages = "89--93",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "Wiley-Blackwell",
number = "1",

}

Van Doorn, HC, Timmermans, A, Opmeer, BC, Kruitwagen, RFMP, Dijkhuizen, FPHLJ, Kooi, GS, Van De Weijer, PHM & Mol, BWJ 2008, 'What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?', Acta Obstetricia et Gynecologica Scandinavica, vol. 87, no. 1, pp. 89-93. https://doi.org/10.1080/00016340701763130

What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding? / Van Doorn, H. C.; Timmermans, A.; Opmeer, B. C.; Kruitwagen, R. F M P; Dijkhuizen, F. P H L J; Kooi, G. S.; Van De Weijer, P. H M; Mol, B. W J.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 87, No. 1, 2008, p. 89-93.

Research output: Contribution to journalArticle

TY - JOUR

T1 - What is the recurrence rate of postmenopausal bleeding in women who have a thin endometrium during a first episode of postmenopausal bleeding?

AU - Van Doorn, H. C.

AU - Timmermans, A.

AU - Opmeer, B. C.

AU - Kruitwagen, R. F M P

AU - Dijkhuizen, F. P H L J

AU - Kooi, G. S.

AU - Van De Weijer, P. H M

AU - Mol, B. W J

PY - 2008

Y1 - 2008

N2 - Objective. To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness ≤4 mm after a first episode of postmenopausal bleeding. Methods. Consecutive patients not using hormone replacement therapy (HRT) presenting with a first episode of postmenopausal bleeding and an endometrial thickness ≤4 mm at transvaginal ultrasonography (TVU) were managed expectantly. In case of recurrent bleeding, the patient was evaluated according to the hospital's local policy with TVU, office endometrial sampling, hysteroscopy or dilatation and curettage (D&C) or a combination of these tests. We evaluated the incidence of recurrent bleeding, potential risk factors for recurrent bleeding, and the diagnosis made after recurrent bleeding. Results. A total of 607 patients were registered with a first episode of postmenopausal bleeding, of whom 249 had an endometrial thickness ≤4 mm. Follow-up took place with a median of 174 weeks (range: 4-250 weeks). During follow-up, 25 of the 249 patients (10%; 95% CI: 6.6-14%) had recurrent bleeding. Median time until recurrence of bleeding was 49 weeks (range: 9-186 weeks). Two patients with recurrent bleeding turned out to have an endometrial carcinoma (8%; 95% CI: 2.2-25%), and 1 patient had a malignant melanoma. Time since menopause, age, body mass index, hypertension, diabetes and anticoagulants were not predictive for recurrent bleeding. Conclusion. The recurrence rate after a first episode of postmenopausal bleeding managed expectantly is low and cannot be predicted by patient characteristics. Patients with recurrent bleeding should be re-evaluated, as they bear a considerable risk of carcinoma.

AB - Objective. To determine the incidence and significance of recurrent postmenopausal bleeding among women diagnosed with an endometrial thickness ≤4 mm after a first episode of postmenopausal bleeding. Methods. Consecutive patients not using hormone replacement therapy (HRT) presenting with a first episode of postmenopausal bleeding and an endometrial thickness ≤4 mm at transvaginal ultrasonography (TVU) were managed expectantly. In case of recurrent bleeding, the patient was evaluated according to the hospital's local policy with TVU, office endometrial sampling, hysteroscopy or dilatation and curettage (D&C) or a combination of these tests. We evaluated the incidence of recurrent bleeding, potential risk factors for recurrent bleeding, and the diagnosis made after recurrent bleeding. Results. A total of 607 patients were registered with a first episode of postmenopausal bleeding, of whom 249 had an endometrial thickness ≤4 mm. Follow-up took place with a median of 174 weeks (range: 4-250 weeks). During follow-up, 25 of the 249 patients (10%; 95% CI: 6.6-14%) had recurrent bleeding. Median time until recurrence of bleeding was 49 weeks (range: 9-186 weeks). Two patients with recurrent bleeding turned out to have an endometrial carcinoma (8%; 95% CI: 2.2-25%), and 1 patient had a malignant melanoma. Time since menopause, age, body mass index, hypertension, diabetes and anticoagulants were not predictive for recurrent bleeding. Conclusion. The recurrence rate after a first episode of postmenopausal bleeding managed expectantly is low and cannot be predicted by patient characteristics. Patients with recurrent bleeding should be re-evaluated, as they bear a considerable risk of carcinoma.

KW - Endometrial thickness ≤4 mm

KW - Postmenopausal bleeding

KW - Recurrence rate

UR - http://www.scopus.com/inward/record.url?scp=37549003324&partnerID=8YFLogxK

U2 - 10.1080/00016340701763130

DO - 10.1080/00016340701763130

M3 - Article

VL - 87

SP - 89

EP - 93

JO - Acta Obstetricia et Gynecologica Scandinavica

T2 - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 1

ER -