Assessment of perimenopausal bleeding

Background: Abnormal uterine bleeding (AUB) is one of the most common presenting complaints encountered in a Gynecologist's office and accounts for almost 10% consultations in any busy out-patient clinic. Perimenopause is defined as the time around menopause during which menstrual cycle and endocrine changes are occurring but 12 months of amenorrhea has not yet occurred. Patients usually present first to their family physicians, who can do most of the diagnostic workup and management.Methods: 200 women of perimenopausal age group with AUB presenting to gynecology OPD and wards of Department of Obstetrics and Gynecology, SAMC & PGI, Indore. The study was conducted from May 2013 to April 2014.Results: In our present study majority (57%) of the women in our study were in the age group 40-45 years and rest were having age more than 46 years. In our present study 52% of the women presented with menorrhagia, 16.5% presented with polymenorrhagia, 11.5% presented with metropathia haemorrhagica, 9% presented with polymenorrhoea, 4.5% presented with metrorrhagia.Conclusions: There are various menstrual irregularities during perimenopausal period, some due to variation in hormones which are physiological some due to pathological changes. Every case of perimenopausal bleeding needs evaluation. Base line investigations should be offered to all the patients. Public awareness programme in the community and yearly physical checkup should be advised to all the patients