Case 19 - Postmenopausal bleed

Question 1

1.What are the important features of the history and examination to cover when assessing a woman with postmenopausal bleeding?

Answer 1

-Blood - when, duration, pattern, amount, frequency, trauma
-change in bladder or bowel function
-weight loss, pain
-HRT - type, duration
-hysterectomy
-pmh, gyne hist, obs, meds, social, fam eect.
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Question 2

2.What are the common and important causes of postmenopausal bleeding?

Answer 2

• atrophy (vaginal, endometrial, urogenital)
• exogenous oestrogen
• polyps (endometrial/cervical)
• Endometrial hyperplasia
• endometrial cancer
• cervical cancer