ABNORMAL UTERINE BLEEDING IN THE PERIMENOPAUSE

Abnormal uterine bleeding is probably one of the most common gynecolog ic complaints in the perimenopause. It is a significant cause of hyste rectomy, which is the second most common surgical procedure performed on women in the United States, and thus is a major health issue. Manag ement consists of a stepwise evaluation of all possible organic causes of uterine bleeding. Advancements in technology have allowed consider able improvements in the resolution of many diagnostic tools. Direct v isualization of the uterine cavity is now an invaluable adjunct to bli nd endometrial sampling. Consequently, therapy can be tailored more ap propriately and efficiently, either by newly developed medical strateg ies or through selective, minimally invasive surgery. In light of thes e perspectives, some of the recent diagnostic and therapeutic trends i n the management of abnormal uterine bleeding in perimenopausal women are presented.