Postmenopausal Bleeding: Causes, Symptoms, and Treatment Options

Postmenopausal bleeding (PMB) is defined as any vaginal bleeding that occurs after the cessation of menses and is a common symptom in postmenopausal women. It can be caused by a variety of factors, including hormonal changes, endometrial polyps or cancer, cervical cancer, and vaginal or vulval lesions.
Postmenopausal bleeding is often a symptom of an underlying condition that requires evaluation and treatment. The risk of developing endometrial cancer increases with age, and PMB is one of the most common presenting symptoms of endometrial cancer in postmenopausal women. Other potential causes of PMB include:

1. Endometrial polyps: These are growths on the lining of the uterus that can cause bleeding.
2. Cervical cancer: This is a type of cancer that occurs in the cervix and can cause bleeding.
3. Vaginal or vulval lesions: These are abnormal growths or sores in the vagina or vulva that can cause bleeding.
4. Hormonal changes: After menopause, hormone levels change, which can lead to irregular bleeding.
5. Uterine fibroids: These are noncancerous growths in the uterus that can cause bleeding.
6. Ovarian cysts: These are fluid-filled sacs on the ovaries that can cause bleeding when they rupture.
7. Endometrial atrophy: This is a thinning of the lining of the uterus that can cause irregular bleeding.
8. Adenocarcinoma in situ (AIS): This is a precancerous condition that can cause bleeding.
9. Other causes: There are several other potential causes of PMB, including thyroid disorders, blood clotting disorders, and certain medications.

It is important to note that PMB can be a symptom of an underlying serious condition, such as endometrial cancer or cervical cancer, so it is important to seek medical attention if you experience this symptom. A healthcare provider will perform a thorough evaluation, including a physical examination, pelvic ultrasound, and possibly a biopsy, to determine the cause of PMB and develop an appropriate treatment plan.