Pearl obstetrics | gynaecology

Bleeding after the menopause (PMB)

Post menopausal bleeding

PMB – Why is bleeding after the menopause important?

Bleeding after the menopause (post-menopausal bleeding or PMB) almost always needs to be investigated, as it may sometimes be a sign of cancer. In most cases 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.
Cervical and endometrial polyps - small growths that are usually benign.
Endometrial (uterine) or cervical cancer - 10 % of cases – both are very serious conditions.


What should I do now?

Call us if you have PMB and we’ll fit you in 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.
Dr. Mark Sillender. Consultant obstetrician & gynaecologist