PMB | Bleeding after menopause | Glengarry Private Hospital

Why is bleeding after the menopause important?

Bleeding after the menopause (post-menopausal bleeding or PMB) almost always needs to be investigated. It may sometimes be a sign of cancer. In most cases however, cancer can be ruled out after tests. If it is cancer, detecting it early can often result in good prospects for a cure.

What causes PMB?
In 90% of cases there won’t be a serious cause. The common causes are:

Atrophic vaginitis - which is when the vagina becomes inflamed due to the lower levels of hormones seen after menopause. It can be easily managed with special cream.
Cervical and endometrial polyps – small growths that are usually benign.These can easily be removed using hysteroscopy.
Endometrial (uterine) or cervical cancer – up to 10% of cases – both are very serious conditions and need to be diagnosed and treated as soon as possible.

What should I do now?
Call us if you have abnormal bleeding and we’ll fit you in for an appointment & any subsequent surgery as soon as we can.

What tests are needed?
Tests that we do may include

• PAP smear test
• colposcopy examination
• vaginal ultrasound scan
• Pipelle biopsy of the womb
• Direct examination of the womb using a thin telescope called a hysteroscope, under an anaesthetic, in operating theatre.

Whilst scans are very helpful with bleeding after the menopause, they only have a 95% accuracy rate. Therefore, in most cases a hysteroscopy examination is the “gold standard” test. If you have a polyp inside, this can be removed at the same time as a hysteroscopy.