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(Bleeding, Postmenopausal; PMB)

Definition

Postmenopausal bleeding (PMB) is vaginal bleeding that happens 12 months after a woman’s last menstrual period or in women taking hormone replacement therapy (HRT).

Female Reproductive Organs
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Causes

Some causes are:

Risk Factors

Some health problems and medicines can raise the risk of this problem.

Symptoms

Vaginal bleeding is a symptom of PMB.

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. It will include a pelvic exam.

The pelvic organs will need to be viewed. This can be done with:

  • Transvaginal ultrasound
  • Hysteroscopy
  • Saline infusion sonohysterography

Cell and tissue samples will be needed for testing. This can be done with:

  • Endometrial biopsy
  • Cervical cancer screening

Treatment

Treatment will depend on the cause of the bleeding.

Prevention

There are no current guidelines to prevent PMB.

RESOURCES

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

Office on Women's Health  https://www.womenshealth.gov 

CANADIAN RESOURCES

Canadian Women's Health Network  http://www.cwhn.ca 

Society of Obstetricians and Gynaecologists of Canada  https://sogc.org 

References

Perimenopausal bleeding and bleeding after menopause. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/patient-resources/faqs/gynecologic-problems/perimenopausal-bleeding-and-bleeding-after-menopause. Updated November 2018. Accessed July 22, 2020.

Postmenopausal bleeding. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/postmenopausal-bleeding  . Updated February 18, 2019. Accessed July 22, 2020.

Sonohysterography. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=hysterosono. Updated February 25, 2018. Accessed July 22, 2020.

Turnbull H, Glover A, et al. Investigation and management of abnormal peri-menopausal bleeding. Menopause Int. 2013 Dec;19(4):147-154.

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