Postmenopausal Bleeding
(Bleeding, Postmenopausal; PMB)
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.
PMB should always be reported to a doctor. In most cases, it is not serious. In others, it can be the first sign of a serious disease.
Causes
PMB may be caused by several factors. These may include:
Risk Factors
Some medical conditions and medications you take can increase your chances of having PMB.
Symptoms
The most common indication of PMB is vaginal bleeding.
PMB is a symptom of another condition. 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
Your doctor will ask 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
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, your doctor will refer you to an oncologist, a doctor who specializes in treating cancer.
Prevention
PMB cannot be prevented.
RESOURCES
American Congress of Obstetricians and Gynecologists
http://www.acog.org
US Department of Health and Human Services Womens Health
http://www.womenshealth.gov
CANADIAN RESOURCES
Health Canada
http://www.hc-sc.gc.ca
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org
References
American College of Obstetricians and Gynecologists (ACOG) Committee Opinion on role of transvaginal ultrasonography in evaluation of postmenopausal bleeding.
Obstet Gynecol. 2009;113(2):462.
Gale A, Dey P. Postmenopausal bleeding.
Menopause Int. 2009;15(4):160-164.
Perimenopausal bleeding and bleeding after menopause. American Congress of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/~/media/For%20Patients/faq162.pdf?dmc=1&ts=20121221T1430328285. Accessed April 22, 2013.
Postmenopausal bleeding. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated May 17, 2012. Accessed April 22, 2013.
Sonohysterography. American College of Radiology Radiology Info website. Available at:
http://www.radiologyinfo.org/en/info.cfm?pg=hysterosono. Updated March 7, 2013. Accessed April 22, 2013.