For some women, PMB does have a serious cause. Pre-cancer change or even cancer of the cervix, uterus (endometrium) or the ovaries may be responsible. For this reason we investigate all cases of PMB very carefully to be sure that these causes are excluded. Assessment will involve a vaginal examination at the clinic visit. A cervical smear may also be necessary and usually an ultrasound test is recommended. These tests are of ten all that is required to give reassurance and advice on treatment, but sometimes further tests are required, most commonly a hysteroscopy examination.
Hysteroscopy is performed with either a general or local anaesthetic but is a very minor procedure (less than 5 minutes) which allows the gynaecologist to look inside the uterus by passing a very fine endoscope (camera) through the cervix. This is a very useful test to get more detailed information and to undertake simple treatments for many minor problems (e.g. polyps or small fibroids) which can cause abnormal bleeding.
Women taking Tamoxifen treatment.
Women who have recently started taking HRT
