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Persistent intermenstrual bleeding — DRCOG MCQ

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ModerateGynaecological OncologyPersistent intermenstrual bleedingDRCOG

A 47-year-old woman has persistent intermenstrual bleeding for 5 months. Pregnancy test is negative, STI tests are negative and speculum examination is normal. Initial ultrasound shows an endometrial thickness higher than expected. When should this patient be referred?

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Correct answer: C — Refer to gynaecology for endometrial assessment

Persistent intermenstrual bleeding with abnormal endometrial findings warrants gynaecology assessment, often with hysteroscopy or biopsy depending on local pathways. A normal cervix does not exclude endometrial pathology. Negative STI tests make infection less likely. Waiting until menopause could delay diagnosis of hyperplasia or cancer.

Reference: NICE NG88; NICE NG12