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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.

Female Reproductive Organs

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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

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

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.

RESOURCES:

American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women's Health—US Department of Health and Human Services
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. Updated May 2011. Accessed March 18, 2014.

Postmenopausal bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 17, 2012. Accessed March 18, 2014.

Sonohysterography. American College of Radiology Radiology Info website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=hysterosono. Updated July 16, 2013. Accessed March 18, 2014.



Last reviewed March 2014 by Andrea Chisholm, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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