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Clinical study of 381 postmenopausal bleeding patients

H H Lin1, M Y Wu, M K Shyu

  • 1Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, R.O.C.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|March 1, 1993
PubMed
Summary

Postmenopausal bleeding evaluation revealed malignancy incidence, with cervical cancer being more prevalent than endometrial cancer. Obesity is a significant risk factor, necessitating fractional curettage for accurate diagnosis.

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Area of Science:

  • Gynecology
  • Oncology
  • Pathology

Background:

  • Abnormal vaginal bleeding in postmenopausal women requires thorough investigation.
  • Understanding the causes, malignancy rates, and risk factors is crucial for timely diagnosis and management.

Purpose of the Study:

  • To evaluate the etiology, incidence of malignancy, clinical risk factors, and time interval to abnormal vaginal bleeding in postmenopausal women.
  • To compare the incidence of cervical versus endometrial malignancies in this cohort.

Main Methods:

  • Retrospective study of 381 postmenopausal women with abnormal vaginal bleeding at National Taiwan University Hospital (1989-1991).
  • Inclusion criteria: complete medical history and available histologic findings.
  • Analysis of histologic findings including normal, benign, premalignant, and malignant conditions.

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Main Results:

  • 212 (55.6%) had normal histology, 83 (21.9%) had benign findings.
  • Malignancy and premalignancy: 14 (3.6%) cervical intraepithelial neoplasia (CIN), 42 (11%) endometrial hyperplasia, 19 (5%) cervical cancer, 11 (2.9%) endometrial cancer.
  • Cervical intraepithelial neoplasia III or cervical cancer (7.6%) was twice as common as endometrial atypical hyperplasia and endometrial cancer (3.4%). Obesity was a significant risk factor for malignancy.

Conclusions:

  • Postmenopausal bleeding warrants investigation for cervical and endometrial pathologies.
  • Cervical malignancies, including CIN III, were more frequent than endometrial malignancies in this study population.
  • Fractional curettage is recommended for accurate diagnosis and management of postmenopausal bleeding.