Postmenopausal bleeding

Question 1

What is postmenopausal bleeding?

Answer 1

Postmenopausal bleeding is any vaginal bleeding that occurs more than 12 months after the last menstrual period in women who are not receiving hormone therapy.

Question 2

How does the definition of postmenopausal bleeding change in someone on HRT?

Answer 2

If a woman is receiving hormone replacement therapy (HRT), bleeding is considered postmenopausal if it occurs more than 6 months after menstruation has stopped.

Question 3

What are the most common causes of postmenopausal bleeding?

Answer 3

endometrial atrophy, vaginal atrophy, endometrial polyps, uterine fibroids, and endometrial cancer.

Question 4

What are less common causes of postmenopausal bleeding?

Answer 4

cervical cancer, ovarian tumours and certain medications, such as hormone replacement therapy (HRT) and anticoagulants.

Question 5

Apart from bleeding post menopause, what are other less symptoms?

Answer 5

Pelvic pain, weight loss, and systemic symptoms of malignancy.

Question 6

What are 3 investigations for postmenopausal?

Answer 6

1. Referral to gynaecology
2. Transvaginal ultrasound to look for abnormal thickening of the endometrium
3. Biopsy of the endometrium, obtained via hysteroscopy or pipelle