Post-Menopausal Bleeding

Vocabulary flashcards covering definition, causes, clinical presentation, and diagnostic workup for post-menopausal bleeding.

Post-menopausal Bleeding

Vaginal bleeding occurring after one year of the last menstrual period.

Endometrial Causes of Post-menopausal Bleeding

Endometrial polyps, endometrial hyperplasia, endometrial cancer, atrophic endometritis, and iatrogenic bleeding with estrogen therapy.

Cervical Causes of Post-menopausal Bleeding

Cervical polyps and cervical cancer.

Vaginal Causes of Post-menopausal Bleeding

Atrophic vaginitis, vaginal cancer, and trauma (e.g., post-coital).

Clinical Features of Atrophic Vaginitis

Mild bleeding or blood-tinged discharge, usually associated with local symptoms, particularly intense burning and dyspareunia if sexually active.

Non-genital Bleeding Differential

Exclusion of non-genital sources of bleeding, such as hemorrhoids or urethral caruncle.

Transvaginal Sonography (TVS)

The first step in evaluation of post-menopausal bleeding to diagnose organic problems and measure endometrial thickness.

Normal Postmenopausal Endometrial Thickness

Postmenopausal endometrium should be $< 5\,\text{mm}$ on transvaginal sonography.

Saline Infusion Sonography (SIS)

A diagnostic procedure that delineates intracavitary problems.

Diagnostic Hysteroscopy

A procedure that can be done in the office without anesthesia to evaluate the uterine cavity and allow biopsy from suspicious areas.

Endometrial Biopsy

An in-office diagnostic workup procedure for evaluating post-menopausal bleeding.

Dilatation and Curettage (D&C)

A procedure used as part of the diagnostic workup for post-menopausal bleeding.