What is Postmenopausal bleeding?
Bleeding through the vagina in a woman following cessation of periods for 12 consecutive months.
Bleeding can be from uterus, cervix, vagina, urological.
How serious is postmenopausal bleeding?
The seriousness of the bleeding depends on the quantity of bleeding and the cause of bleeding. The bleeding can be due to benign conditions of the uterus and vagina but there is always a possibility of cancer in the uterus (womb), cervix, vagina.
The risk of malignancy of uterus is 4.9 – 11.5%. This risk of malignancy increases in patients taking hormone replacement therapy (HRT) or on certain medications for treatment of breast cancer.
How does a doctor evaluate patients with postmenopausal bleeding?
After taking history and thorough examination, a pelvic ultrasound scan is performed to know the condition of the uterus, cervix, ovaries. If the thickness of the endometrium is > 4 mm then, a Hysteroscopy guided endometrial biopsy is done for microscopic evaluation of the inner lining of uterus called endometrium.
The importance of screening tests for detection of health problems has led to many people undergoing Complete Health checks in hospitals. Some people though asymptomatic but with high endometrial thickness > 4 mm, will require evaluation to exclude uterine cancers.