Definition

Postmenopausal bleeding (PMB) is bleeding from the vagina that happens after a woman has stopped having regular menstrual periods due to menopause. Any vaginal bleeding that occurs 12 months after a woman’s last menstrual period is considered PMB.

Female Reproductive Organs

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Causes

PMB may be caused by several factors. These may include:

    
  • Continuous hormone replacement therapy (HRT)
  • Thinning and loss of elasticity of the vagina
  • Inflammation of the endometrium, the lining of the uterus
  • Endometrial hyperplasia, a thickening of endometrium
  • Polyps, noncancerous growths on the uterus or cervix
  • Infection of the uterus or cervix
  • Endometrial cancer
  • Cervical cancer
  • Fibroid tumors in the uterus or vagina
  • Risk Factors

    Some medical conditions and medications you take can increase your chances of having PMB.

    Symptoms

    Vaginal bleeding is a symptom of PMB. Your doctor can determine what condition is causing the bleeding and whether it is serious. If you have PMB, you should see your doctor.

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.

    Tests will be done to find the cause of the bleeding. Tests include:

        
  • Transvaginal ultrasound
  • Saline infusion sonohysterography
  • Hysteroscopy
  • MRI scan
  • Your doctor may need cell and tissue samples. This can be done with:

        
  • Cervical cancer screening
  • Endometrial biopsy
  • Treatment

    Talk with your doctor about the best treatment plan for you. The first priority is ruling out cancer. Treatment will depend on the findings of your tests and the cause of the bleeding. For instance, if your tests show signs of cancer, you will be referred to an oncologist, a doctor who specializes in treating cancer.

    Prevention

    PMB cannot be prevented.