Postmenopausal Bleeding: a Warning Symptom

Objective: Pathological evaluation of postmenopausal bleeding.

Settings: Department of Obstetrics&Gynaecology, Pt. J. N. M. Medical college & DR. B. R. Ambedkar Memorial, Hospital, Raipur (C. G.)

Study design: Cross sectional Participants: 100

Material and Methods: A detailed, pre-tested, structured, closed questionnaire was used to collect the data. According to the case, cervical cytology and biopsy from any suspicious lesion or growth from cervix, vagina or vulva was taken. Results were analyzed using percentages.

Results: 65% of cases were of malignant origin. Carcinoma cervix came out to be the most common malignancy causing postmenopausal bleeding, representing 60% of total cases. Most of the cancer cervix cases were in advanced stages. Carcinoma endometrium and Carcinoma vulva were other malignancies found. The most common benign lesion associated with postmenopausal bleeding was Cervical Polyp, responsible for 25.7% of all benign cases. Incidence of malignancy increased with increasing age and with increasing clear span.

Conclusions: There in an urgent need for increasing awareness about the importance of postmenopausal bleeding. It is imperative to maintain a high index of suspicion and evaluate postmenopausal bleeding thoroughly considering it malignancy unless proved otherwise. Emphasis should be placed on screening of carcinoma cervix in pre-invasive stage, when it is symptomless and curable.