Different Modalities for the Evaluation of Patients With Peri-menopausal Bleeding

Inclusion Criteria: Any pattern of abnormal uterine bleeding as menorrhagia or metrorrhagia for more than 3 months at age between 40 and 55 years , and no ovarian lesion or local cause of bleeding as vaginal or cervical ulcer Exclusion Criteria: * • Women with postmenopausal bleeding. * Systemic causes of perimenopausal bleeding DM Hypertension or chronic liver disease. * Women on hormonal therapy or using any contraception as IUD. * Women have contraindication for hysteroscopy as cervical stenosis or pregnancy.