(Bleeding, Postmenopausal; PMB)
Postmenopausal bleeding (PMB) is vaginal bleeding that happens 12 months after a woman’s last menstrual period or in women taking hormone replacement therapy (HRT).
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Some causes are:
Some health problems and medicines can raise the risk of this problem.
Vaginal bleeding is a symptom of PMB.
You will be asked about your symptoms and health history. A physical exam will be done. It will include a pelvic exam.
The pelvic organs will need to be viewed. This can be done with:
- Transvaginal ultrasound
- Saline infusion sonohysterography
Cell and tissue samples will be needed for testing. This can be done with:
- Endometrial biopsy
- Cervical cancer screening
Treatment will depend on the cause of the bleeding.
There are no current guidelines to prevent PMB.
The American Congress of Obstetricians and Gynecologists
Office on Women's Health
Canadian Women's Health Network
Society of Obstetricians and Gynaecologists of Canada
Perimenopausal bleeding and bleeding after menopause. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/patient-resources/faqs/gynecologic-problems/perimenopausal-bleeding-and-bleeding-after-menopause. Updated November 2018. Accessed July 22, 2020.
Postmenopausal bleeding. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/postmenopausal-bleeding. Updated February 18, 2019. Accessed July 22, 2020.
Sonohysterography. Radiology Info—Radiological Society of North America website. Available at: https://www.radiologyinfo.org/en/info.cfm?pg=hysterosono. Updated February 25, 2018. Accessed July 22, 2020.
Turnbull H, Glover A, et al. Investigation and management of abnormal peri-menopausal bleeding. Menopause Int. 2013 Dec;19(4):147-154.
Last reviewed March 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG Last Updated: 7/22/2020