Postmenopausal bleeding refers to unexpected vaginal bleeding in a woman who has reached the menopause, taken as at least 12 months’ amenorrhoea.
Urgent evaluation is required as 5% of cases the underlying cause is life-threatening endometrial cancer.
Ultrasound scan to assess thickness of lining of the womb [endometrium].
A sample of the endometrium [endometrial biopsy] is obtained to exclude endometrial pathology, including cancer.
Hysteroscopy is recommended to assess the endometrium and allows removal of benign pathology at the same procedure. This procedure may be done under local or general anaesthesia.
Depending on the cause and the results of investigations, this may be treated by medical or surgical approach.