A avaliação diagnóstica do sangramento uterino pós-menopausa / Diagnostic evaluation of postmenopausal uterine bleeding

Lineker Souza do Amaral, Karinne Nancy Sena Rocha, Luciane Mari Brito Cavalcante, Renata França Ferreira, Mariana Reis Barreto, Carlos Herique Rodrigues de Paulo, Flávia Alessandra Pereira Neves, Luma Leonardo Luciano de Lucena

Abstract


O sangramento pós-menopausa refere-se a qualquer sangramento uterino em uma mulher na menopausa (exceto o sangramento cíclico esperado que ocorre em mulheres em terapia hormonal pós-menopausa cíclica). É responsável por aproximadamente 5% das consultas de ginecologia em consultório. O sangramento pós-menopausa refere-se a qualquer sangramento uterino em uma mulher na menopausa. A atrofia endometrial e pólipos endometriais são as causas mais comuns de sangramento pós-menopausa, o carcinoma endometrial é a causa em aproximadamente 9% dos pacientes em geral. O objetivo principal na avaliação diagnóstica de mulheres na pós-menopausa com sangramento uterino é excluir a malignidade. O sangramento uterino em mulheres na pós-menopausa geralmente é leve e autolimitado, a exclusão do câncer é o objetivo principal, portanto, o tratamento geralmente é desnecessário uma vez que o câncer foi excluído. 


Keywords


Pós-menopausa, Sangramento, Mulheres.

References


Moodley M, Roberts C. Clinical pathway for the evaluation of postmenopausal bleeding with an emphasis on endometrial cancer detection. J Obstet Gynaecol 2004; 24:736.

Astrup K, Olivarius Nde F. Frequency of spontaneously occurring postmenopausal bleeding in the general population. Acta Obstet Gynecol Scand 2004; 83:203.

Ferenczy A. Pathophysiology of endometrial bleeding. Maturitas 2003; 45:1.

Doherty L, Mutlu L, Sinclair D, Taylor H. Uterine fibroids: clinical manifestations and contemporary management. Reprod Sci 2014; 21:1067.

Paramsothy P, Harlow SD, Greendale GA, et al. Bleeding patterns during the menopausal transition in the multi-ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study. BJOG 2014; 121:1564.

Reinhold C, McCarthy S, Bret PM, et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996; 199:151.

Shoff SM, Newcomb PA. Diabetes, body size, and risk of endometrial cancer. Am J Epidemiol 1998; 148:234.

van Hunsel FP, Kampschöer P. [Postmenopausal bleeding and dietary supplements: a possible causal relationship with hop- and soy-containing preparations]. Ned Tijdschr Geneeskd 2012; 156:A5095.

Güngördük K, Ulker V, Sahbaz A, et al. Postmenopausal tuberculosis endometritis. Infect Dis Obstet Gynecol 2007; 2007:27028.

Capmas P, Pourcelot AG, Giral E, et al. Office hysteroscopy: A report of 2402 cases. J Gynecol Obstet Biol Reprod (Paris) 2016; 45:445.

Doll KM, Romano SS, Marsh EE, Robinson WR. Estimated Performance of Transvaginal Ultrasonography for Evaluation of Postmenopausal Bleeding in a Simulated Cohort of Black and White Women in the US. JAMA Oncol 2021; 7:1158.

Chandavarkar U, Kuperman J, Muderspach L, et al. Postmenopausal endometrial cancer: Reevaluating the role of endometrial echo complex. Gynecol Oncol 2011; 120:S11.

Sabadell J, Castellví J, Baró F. Tuberculous endometritis presenting as postmenopausal bleeding. Int J Gynaecol Obstet 2007; 96:203.

Burbos N, Musonda P, Giarenis I, et al. Age-related differential diagnosis of vaginal bleeding in postmenopausal women: a series of 3047 symptomatic postmenopausal women. Menopause Int 2010; 16:5.

Prendergast EN, Misch E, Chou YA, et al. Insufficient endometrial biopsy results in women with abnormal uterine bleeding. Obstet Gynecol 2014; 123 Suppl 1:180S.

Mengistu Z, Engh V, Melby KK, et al. Postmenopausal vaginal bleeding caused by endometrial tuberculosis. Acta Obstet Gynecol Scand 2007; 86:631.

Van den Bosch T, Ameye L, Van Schoubroeck D, et al. Intra-cavitary uterine pathology in women with abnormal uterine bleeding: a prospective study of 1220 women. Facts Views Vis Obgyn 2015; 7:17.

Duffy S, Jackson TL, Lansdown M, et al. The ATAC adjuvant breast cancer trial in postmenopausal women: baseline endometrial subprotocol data. BJOG 2003; 110:1099.

Clarke MA, Long BJ, Del Mar Morillo A, et al. Association of Endometrial Cancer Risk With Postmenopausal Bleeding in Women: A Systematic Review and Meta-analysis. JAMA Intern Med 2018; 178:1210.

Munro MG, Southern California Permanente Medical Group’s Abnormal Uterine Bleeding Working Group. Investigation of women with postmenopausal uterine bleeding: clinical practice recommendations. Perm J 2014; 18:55.

Unfer V, Casini ML, Costabile L, et al. Endometrial effects of long-term treatment with phytoestrogens: a randomized, double-blind, placebo-controlled study. Fertil Steril 2004; 82:145.




DOI: https://doi.org/10.34119/bjhrv5n1-023

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