Recent advances in evaluation and management of postmenopausal bleeding

Postmenopausal bleeding (PMB) is one of the most common reasons in patients attending gynecological OPD. It is a frequent and alarming sign of endometrial cancer though the commonest cause is an atrophic endometrium. Women with PMB are categorized as those with spontaneous bleeding and those with bleeding whilst on Tamoxifen or HRT. All these patients should be investigated by TVS, hysteroscopy and D&C and accordingly should be managed.Postmenopausal bleeding (PMB) is defined as a bleeding which occurs after 12 months of amenorrhea due to loss of ovarian follicular activity in a woman who is not on hormone replacement therapy (HRT). Women with abnormal postmenopausal bleeding also include:
• Women with bleeding after 1 year of continuous combined HRT
• Women with unexpected bleeding while receiving cyclic HRT