Postmenopausal bleeding

Postmenopausal bleeding is an abnormal uterine bleeding that occurs after the menopause. It is defined as bleeding that occurs more than 12 months after the last menstrual period. Postmenopausal bleeding is a common symptom seen in gynecological practice, with an incidence of approximately 10% in the postmenopausal population.

Causes

The most common cause of postmenopausal bleeding is atrophy of the endometrium or vagina, which accounts for approximately 90% of cases. Other causes include endometrial polyps, endometrial hyperplasia, endometrial cancer, and cervical cancer. Less common causes include uterine fibroids, ovarian tumors, polycystic ovary syndrome, and pelvic inflammatory disease.

Diagnosis

The diagnosis of postmenopausal bleeding is made based on the patient's history, physical examination, and diagnostic tests. The initial evaluation should include a pelvic examination to assess for any abnormalities. Diagnostic tests may include transvaginal ultrasound, endometrial biopsy, and hysteroscopy.

Treatment

The treatment of postmenopausal bleeding depends on the underlying cause. In cases of atrophy, treatment may include estrogen therapy or vaginal moisturizers. For endometrial polyps or fibroids, surgery may be required. In cases of endometrial or cervical cancer, treatment may include surgery, radiation therapy, and/or chemotherapy.

See also

• Menopause
• Endometrial cancer
• Cervical cancer
• Endometrial hyperplasia

Postmenopausal bleeding Resources
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