Postmenopausal Bleeding an Overview: Comprehensive Guide for Postmenopausal Bleeding

Menopause is derived from the Greek words, men (month) and pause (cessation). Menopause is defined as the permanent cessation of menses for more than one year and is physiologically correlated with the decline in estrogen secretion resulting from the loss of follicular function. So postmenopausal bleeding is defined as bleeding from the genital tract after the cessation of menstruation for more than one year. It is one of the most common problems affecting women after menopause . Postmenopausal bleeding is often the first and principal symptom of endometrial cancer and be regarded as a symptom of genital tract malignancy until proved otherwise. Atrophic endometritis and vaginitis, endometrial cancer, endometrial or cervical polyps, endometrial hyperplasia, use of exogenous estrogen as a hormonal replacement therapy, and miscellaneous e.g. cervical cancer, uterine sarcoma, urethral caruncle, trauma are considered as other causes. Diagnosis of the cause of the postmenopausal bleeding can be made by the use of different diagnostic procedures of which transvaginal sonography, Doppler and fractional curettage are the most important. Managment depends greatly on the cause.