When treating amenorrhea in a perimenopausal woman with a normal exam, what interval of progestin (Provera) challenge is recommended before bleeding is considered postmenopausal, necessitating endometrial biopsy?—DEBBI LEONARD, RN, CNM, NP, Greensboro, N.C.

Amenorrhea of one year’s duration defines menopause. Menopausal amenorrhea does not need to be treated with Provera. If a postmenopausal woman is bleeding spontaneously (i.e., not in response to Provera), an endometrial biopsy should be considered.—Lisa Stern, APRN (146-1)