1 King Abdulaziz Hospital, Jeddah, Saudi Arabia
2 AlNahdi Clinics, Jeddah, Saudi Arabia
3 Maternity and Children Hospital, Makkah, Saudi Arabia
4 King Abdulaziz University, Medical Service Center University, Jeddah, Saudi Arabia
5 Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
6 National Guard Hospital, Riyadh, Saudi Arabia
7 Royal College of Surgeons, Ireland
8 Hail General Hospital, Hail, Saudi Arabia
9 Taibah University, Madinah, Saudi Arabia
10 Prince Sultan Medical Military City, Riyadh, Saudi Arabia
11 King Abdullah Medical Complex, Jeddah, Saudi Arabia
12 Armed Forces Hospital, Jazan, Saudi Arabia
13 King Salman Medical City, Makkah, Saudi Arabia
Introduction:Post-menopausal bleeding (PMB) is defined as uterine bleeding that occurs after one year of menopause. Amenor- rhoea accounts for 10% of incidence immediately after menopause. One of the other common reasons for post-menstrual bleeding is endometrial carcinoma which occurs in 10 - 15% of cases. Endometrial Cancer, unlike ovarian cancer, presents at an early stage can be treated with hysterectomy, provided timely and accurate diagnosis is made. It is important to notice that lesions such as endo- metrial polyps, fibroids (benign focal lesions) and vaginal atrophy are some common reasons for post-menstrual bleeding, which is prevalent in up to 40% of cases. Risk factors include obesity, polycystic ovary syndrome, unopposed estrogens, and nulliparity. Post- menopausal bleeding mostly has an intrauterine source, but vulva, vagina, cervix, fallopian tubes, or ovarian pathology and cervical stenosis may be some other reasons. The extragenital sites for bleeding are the urethra or bladder and the rectum or bowel. There- fore, a prompt clinical approach is mandatory to evaluate the cause of post-menopausal bleeding and to exclude it from carcinoma of the genital tract or other precancerous lesions of the endometrium.
Aim and Scope:The aim of the review is to understand the various possible causative factors for post-menopausal bleeding and its management.
Methodology:The review is a comprehensive research of PUBMED from the year 2012 to 2021.
Conclusion:There may be multiple reasons for Post-menopausal bleeding, and 10% of them are due to endometrial carcinoma; therefore, post-menopausal bleeding must always be investigated to rule out the cause, the most common among that is atrophic vaginitis or endometritis. Tissue pathology for assessment of endometrium is essential, even if there is an obvious presence of atro- phic vaginitis or polyp. Most of the causative factors can be treated well if diagnosed early and present lesser complication; the prognosis for carcinoma is also usually good since most patients present at an early stage of disease attributed to its early symptom of post-menopausal bleeding.
Keywords: Post-Menopausal Vaginal Bleeding; Carcinoma; Management; Hysterectomy
Fayzah Ahmed Andegani., et al. “Etiology and Management of Post Menopausal Bleeding””. EC Microbiology 18.2 (2022): 43-49.
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