69-year-old woman who comes to your office referring genital bleeding of several months of evolution. She denies hormone replacement therapy and anticoagulation. She provides normal cervicovaginal cytology. General and genital physical examination without findings of interest. BMI of 38kg/m2. Indicate the most correct attitude:
The correct answer is 2. We are dealing with a case of postmenopausal metrorrhagia, whose most frequent cause is genital atrophy in the first place and endometrial cancer in the second place. The data given on obesity should lead us to suspect endometrial cancer, since peripheral fat is converted to estrone, and these estrogens cause the endometrium to proliferate. On the other hand, she provides a normal cytology, which rules out option 3. The hormonal evaluation is not opportune, since we understand that the patient is in menopause. We should not prescribe treatment without first ruling out organic causes.
Prescribe cyclic progesterone.
Endometrial biopsy.
Random cervical biopsies.
Hormonal evaluation with FSH, LH and estradiol.
We should not prescribe treatment without first ruling out organic causes.
We are dealing with a case of postmenopausal metrorrhagia, whose most frequent cause is genital atrophy in the first place and endometrial cancer in the second place.
she provides a normal cytology, which rules out option 3.
The hormonal evaluation is not opportune, since we understand that the patient is in menopause.