Postmenopausal bleeding

Abstract

Postmenopausal bleeding (PMB) is defined as any vaginal bleeding occurring at least 12 months after the last menstrual period, in a woman who is of menopausal age. PMB is a common problem presenting in general practice, and accounts for 5% of secondary care referrals. Although PMB usually has a benign cause, it is important to exclude endometrial cancer, which is detected in approximately 10% of women presenting with PMB. This article offers an outline for the history, examination and initial investigations of PMB, as well as an overview of the common causes and how these are subsequently managed.