Assessment of Postmenopausal Bleeding

Postmenopausal bleeding is bleeding that occurs 12 or more months after the last menstrual period and accounts for 5% of all gynecologic office visits. While it is not always a symptom of cancer, the exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with postmenopausal bleeding. The primary evaluation of postmenopausal women who present with abnormal uterine bleeding includes a medical history and a pelvic examination. Investigative studies, such as a uterine biopsy, ultrasound, hysteroscopy or dilation and curettage, may be required. Treatment will depend on the cause determined. The most important point is that irregular perimenopausal or postmenopausal bleeding should not be ignored or assumed to be a normal phenomenon.