Indian Journal of Public Health Research & Development

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Postmenopausal Bleeding: a Warning Symptom


Affiliations
1 Department of Obstetrics & Gynaecology, Hind Institute of Medical Sciences, Barabanki, Lucknow, India
2 Department of Community Medicine, Career Institute of Medical Sciences, Lucknow, India
3 Department of Obstetrics & Gynaecology, Pt. J. N. M. Medical College & Dr. B. R. Ambedkar Memorial, Hospital, Raipur (C. G.)., India
     

   Subscribe/Renew Journal


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.


Keywords

Postmenopausal Bleeding, Cancer, Cervical Cancer
Subscription Login to verify subscription
User
Notifications
Font Size


  • Breijer MC, Timmermans A, van Doorn HC, Mol BW, Opmeer BC. Diagnostic strategies for postmenopausal bleeding. Obstet Gynecol Int. 2010;2010:850812.

  • Merril JA. Management of postmenopausal bleeding. Clin Obstet Gynaecol. 1981;24(1):285-99.

  • Brewer JI, Miller WH. Postmenopausal uterine bleeding. Am J Obstet and Gynecol. 1954;67(5):988-1009.

  • Kaur M, Singh R, Sharma M. Endovaginal sonographic evaluation of postmenopausal uterine bleeding. Journal of Clinical and Diagnostic Research. 2010;4:2175–82.

  • Lachelin G. ed. The Menopause. In: Introduction to Clinical Reproductive Endocrinology. London: Butterworth-Heinmann. 1991:172-86.

  • Payne FL, Wright RC, Fetterman HH. Am J Obstet and Gynecol. 1959;77(6):1216-27.

  • Keirse MJNC. Etiology of postmenopausal bleeding. Postgraduate Medical Journal. 1973;49:344-348

  • Panda S, Panda SN, Sarangi RK, Habeebullah S. Postmenopausal bleeding. J Indian Med Assoc. 1977;68:185.

  • Lee WH, Tan KH, Lee YW. The aetiology of postmenopausal bleeding—a study of 163 consecutive cases in Singapore. Singapore Med J. 1995;36(2):164–8.

  • Geist SH, Matus M. Postmenopausal bleeding. Am J Obstet and Gynecol. 1933;388-97.

  • Taylor HC Jr, Millen R. The causes of vaginal bleeding and the histology of endometrium after the menopause. Am J Obstet and Gynecol. 1938;36:22.

  • Rubin SC. Postmenopausal bleeding etiology, evaluation and management. Med Clin North Am. 1987;71:59-69.

  • Cospi E, Perpimal S, Reif A. Incidence of malignancy in Jewish women with postmenopausal bleeding. Isr J Med Sc. 1977;13:299-304.

  • Valerie A Omicol. Postmenopausal bleeding. (Online) 2010. Available from URL: www.mainlinehealth.org/whs

  • Youssef A, Ben Aissia N, Gara MF. Postmenopausal uterine bleeding. Analytical study of about 65 cases. Tunis Med. 2005;83: 453-456.

  • Kintio GA, Calvert W. Postmenopausal bleeding one hospital, one year. J Obstet Gynaecol Surv. 1984;39:43-45.

  • Gredmark T, Kvint S, Havel G, Mattsson LA. Histopathological findings in women with postmenopausal bleeding. Br J Obstet Gynaecol. 1995;102:133-6.

  • Pacheco JC, kempers RD. Etiology postmenopausal bleeding. Obstetrics and Gynecology. 1964;32:40.

  • Luiz DA, Moodley J, Richards A. Aetiology of postmenopausal bleeding in black women in Durban. S Afr Med J. 1986;69:674–5

  • Wondwossen Ergette, Abiye Tesfaye. Histopathological findings of PMB in Ethiopian women. Ethiopian J Health Dev. 2001;15:39-44.

  • Liaquat NF, Noorani K. Causes of postmenopausal bleeding: A study of 328 cases. J Call Physicians Surg Pale. 2000;10:134-7.

  • Asif KH, Hamid S. Causes of postmenopausal bleeding. Pak J Obstet Gynaecol. 1997;10:22-6.

  • Panda JK. One-stop clinic for postmenopausal bleeding. J Reprod Med. 2002;47:761–6.

  • Lidor A, Ismajovich B, Cohnfino E et al. Histopathological finding in 226 women with postmenopausal uterine bleeding. Acta Obstet Gynaecol Scand. 1986;65:41-43.

  • Procope BJ. Aetiology of postmenopausal bleeding. Acta Obstet Gynecol Scand 1971;50:311

  • Rai L. Corpus cancer: A clinicopathological audit. J of Obst and Gyne of India. 2001;51(4):158.

  • Ghazi A, Jabbar S, Siddiqui N. Frequency of Endometrial carcinoma in patients with postmenopausal bleeding. Pak J of Surgery. 2005;21:41-4.

  • Brand AH. The woman with postmenopausal bleeding. Aust Fam Physician. 2007;36(3):116-20.


Abstract Views: 347

PDF Views: 0




  • Postmenopausal Bleeding: a Warning Symptom

Abstract Views: 347  |  PDF Views: 0

Authors

Sonia Luthra
Department of Obstetrics & Gynaecology, Hind Institute of Medical Sciences, Barabanki, Lucknow, India
Bhupinder Anand
Department of Community Medicine, Career Institute of Medical Sciences, Lucknow, India
Abha Singh
Department of Obstetrics & Gynaecology, Pt. J. N. M. Medical College & Dr. B. R. Ambedkar Memorial, Hospital, Raipur (C. G.)., India

Abstract


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.


Keywords


Postmenopausal Bleeding, Cancer, Cervical Cancer

References