The woman with postmenopausal bleeding

Postmenopausal bleeding is a common complaint from women seen in general practice.

This article outlines a general approach to such patients and discusses the diagnostic possibilities and their management.

The most common cause of postmenopausal bleeding is atrophic vaginitis or endometritis. However, as 10% of women with postmenopausal bleeding will be found to have endometrial cancer, all patients must be properly assessed to rule out the diagnosis of malignancy. Most women with endometrial cancer will be diagnosed with early stage disease when the prognosis is excellent as postmenopausal bleeding is an early warning sign that leads women to seek medical advice.