RT Journal Article SR Electronic T1 The First-Line Investigation of Postmenopausal Bleeding: Transvaginal Ultrasound Scanning and Endometrial Biopsy May Be Enough JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 892-895 OP 892-895 DO 10.1111/IGC.0b013e3181a83387 VO 19 IS 5 A1 Fadi Alfhaily A1 Ayman A. A. Ewies YR 2009 UL http://ijgc.bmj.com/content/19/5/892-895.abstract AB Postmenopausal bleeding is a common problem in clinical practice with significant implications; however, the diagnostic strategies often vary among different centers. In the recent years, there was a trend to adopt less invasive procedures without compromising efficacy and safety. There is continuous debate about the different available modalities for investigation, and a large number of studies were conducted to define their roles. Some authors recommended that hysteroscopy should be the standard investigation procedure for women with postmenopausal bleeding. Nonetheless, there is a strong evidence to suggest that transvaginal ultrasound scanning, with or without endometrial biopsy, is a safe and more cost-effective initial tool in investigating these women. This commentary highlights this important issue and discusses the role of these different modalities.