Understanding Postmenopausal Bleeding

What is Postmenopausal Bleeding?

Postmenopausal bleeding (PMB) is any vaginal bleeding that occurs at least 12 months after your last menstrual period. This condition should always be evaluated by a healthcare provider, as it can be a sign of serious conditions.

Important Facts

• PMB is not a normal condition
• Approximately 10% of women with PMB have endometrial cancer
• Early evaluation leads to better outcomes

Common Causes

1. Endometrial Atrophy

   • Thinning of uterine lining due to low estrogen
   • Most common cause (60-80% of cases)

2. Endometrial Hyperplasia

   • Thickening of uterine lining
   • Often related to excess estrogen

3. Cancer

   • Endometrial cancer
   • Cervical cancer
   • Vaginal cancer

4. Other Causes

   • Hormone therapy
   • Polyps
   • Infection
   • Trauma

Diagnostic Process

Initial Evaluation

• Medical history review
• Physical examination
• Pelvic examination

Common Tests

• Transvaginal ultrasound
• Endometrial biopsy
• Hysteroscopy (when needed)

Treatment Options

Treatment depends on the underlying cause:

• Atrophy: Topical estrogen
• Polyps: Surgical removal
• Hyperplasia: Hormonal therapy or surgery
• Cancer: Surgery, radiation, or chemotherapy

When to Seek Medical Care

Contact your healthcare provider immediately if you experience:

• Any vaginal bleeding after menopause
• Spotting or brown discharge
• Bleeding after sexual intercourse

Prevention

• Regular gynecological check-ups
• Maintain healthy weight
• Report symptoms promptly
• Follow prescribed medications correctly

Risk Factors

• Obesity
• Diabetes
• Hypertension
• History of irregular menstrual cycles
• Use of certain medications

Outlook

Most causes of PMB are benign and treatable. However, prompt evaluation is essential for optimal outcomes.