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Geriatric Integrated Medicine: Post-Menopausal Bleeding

Topic Information

The Significance of Bleeding after Menopause, Oct 7, 2011: Bleeding after menopause or "postmenopausal bleeding" ("PMB") can be defined as the resumption of vaginal bleeding at least 6 months after a woman experiences her last menstrual period. This assumes of course that she is indeed menopausal ie. in her late 40's, perhaps having hot flashes and night sweats, mood swings, insomnia, perhaps experiencing some vaginal dryness. The bleeding pattern most women experience as they approach menopause is one where the periods become lighter, shorter in duration, and the interval between periods changes so that the periods are either somewhat closer together (between 21-26 days apart) or intervals greater than her customary 28 days. Cycles may be missed entirely for a couple of months.

Source:, Modern Medicine Network

Research from PubMed


Long-term risk of endometrial cancer following postmenopausal bleeding and reassuring endometrial biopsy.


Visser NC, Sparidaens EM, van den Brink JW, Breijer MC, Boss EA, Veersema S, Siebers AG, Bulten J, Pijnenborg JM, Bekkers RL.


Acta Obstet Gynecol Scand. 2016 Dec;95(12):1418-1424. doi: 10.1111/aogs.13022. Epub 2016 Oct 14.


PMID: 27633936 [PubMed - indexed for MEDLINE] Free PMC Article


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Vaginal metastasis presenting as postmenopausal bleeding.


Ng QJ, Namuduri RP, Yam KL, Lim-Tan SK.


Singapore Med J. 2015 Aug;56(8):e134-6. doi: 10.11622/smedj.2015127.


PMID: 26311914 [PubMed - indexed for MEDLINE] Free PMC Article


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Does probability guided hysteroscopy reduce costs in women investigated for postmenopausal bleeding?


Breijer MC, van Hanegem N, Visser NC, Verheijen RH, Mol BW, Pijnenborg JM, Opmeer BC, Timmermans A.


ScientificWorldJournal. 2015;2015:605312. doi: 10.1155/2015/605312. Epub 2015 Feb 16.


PMID: 25785283 [PubMed - indexed for MEDLINE] Free PMC Article


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Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding.


Kim A, Lee JY, Chun S, Kim HY.


Taiwan J Obstet Gynecol. 2015 Jun;54(3):221-6. doi: 10.1016/j.tjog.2013.10.043.


PMID: 26166330 [PubMed - indexed for MEDLINE] Free Article


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Cost-effectiveness of diagnostic strategies for the management of abnormal uterine bleeding (heavy menstrual bleeding and post-menopausal bleeding): a decision analysis.


Cooper NA, Barton PM, Breijer M, Caffrey O, Opmeer BC, Timmermans A, Mol BW, Khan KS, Clark TJ.


Health Technol Assess. 2014 Apr;18(24):1-201, v-vi. doi: 10.3310/hta18240.


PMID: 24767431 [PubMed - indexed for MEDLINE] Free Article


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Investigations for postmenopausal uterine bleeding: special considerations for endometrial volume.


Cho HJ, Lee ES, Lee JY, Hong SN, Ji YI, Kim HY, Kim A.


Arch Iran Med. 2013 Nov;16(11):665-70. doi: 0131611/AIM.0011.


PMID: 24206410 [PubMed - indexed for MEDLINE] Free Article


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Continuing Medical Education (CME)

Guidelines on Post-Menopausal Bleeding

Other Articles of Interest

Patient Handouts about Post-Menopausal Bleeding

Podcasts on Geriatric Post-Menopausal Bleeding

YouTube Videos on Geriatric Post-Menopausal Bleeding

  • Lybrate | Dr Ruby Sehra Talks About Postmenopausal Bleeding, Lyrate, Published on Mar 31, 2018. Postmenopausal bleeding refers to bleeding 12 months or more after the last menstrual period. Any bleeding, even spotting, should trigger a visit to your doctor as soon as possible.
  • Menopause & You: Bleeding After Menopause, Main Line Health, Published on Aug 30, 2012. David Holtz, MD, Chief of Gynecologic Oncology for Main Line Health System, discusses post-menopausal bleeding.
  • Postmenopausal Bleeding, BioBalanceHealthcast, Published on May 4, 2015, 26:22. Dr. Kathy Maupin and Brett Newcomb discuss the issue of postmenopausal bleeding: what it may indicate and what can be done to treat it.
  • Postmenopausal Uterine Bleeding, BioBalanceHealthcast, Published on Feb 17, 2014. Women who suffer from postmenopausal uterine bleeding need to go through a hierarchy of steps in order to deal with it. If it is not caused by uterine cancer, there is really nothing to worry about except for the hassle and the mess. In this weeks podcast, we are talking about Postmenopausal Uterine Bleeding. We discuss why is it happening and what can be done treat it.
  • Post Menopausal Bleeding (AUB) - NAC OSCE Review Course, Canada Osce, Published on Jun 17, 2015, 10:06. This is a short OSCE review of post menopausal bleeding in preparation for the NAC OSCE examination.