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.

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

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.