News|Articles|April 20, 2026

FAQ: Breaking down ACOG's updated guidance for evaluating postmenopausal bleeding

Fact checked by: Benjamin P. Saylor

ACOG now recommends a combination of transvaginal ultrasonography and endometrial tissue sampling for the initial evaluation of most patients presenting with postmenopausal bleeding.

The American College of Obstetricians and Gynecologists (ACOG) has released updated clinical guidance for the evaluation of postmenopausal bleeding, responding to a steady increase in endometrial cancer incidence over recent decades. Given that approximately 90% of patients diagnosed with endometrial cancer present with postmenopausal bleeding, the update aims to provide a more robust framework for earlier and more comprehensive screening to ensure prompt diagnosis.1