Abnormal bleeding can occur at any time in a woman’s life but more commonly after 40 years of age and in particular in the perimenopausal years. This may take the form of irregular heavy periods or bleeding in between periods. The most common cause of this is a hormone imbalance which can be corrected by administering progesterone therapy. Prior to commencing this treatment, it is important to rule out any sinister lesion within the uterus and usually a curette is performed under a general anaesthetic. It is now possible to perform a biopsy of the internal lining of the uterus using a Pipelle endometrial sampler and the can be done in the rooms with minimal discomfort thus avoiding the need for hospitalization and anaesthesia.