The most common causes of PMB is caused by the menopause, such as menopause and include:

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What investigations are carried out?

I will offer you and carry out an internal examination and also a vaginal ultrasound. I will assess your vagina for evidence of vaginal atrophy, I may perform a smear, or carry out some swabs for infection. The scan will assess the endometrial thickness, and if it is less than 6mm, is normal. I may perform an endometrial biopsy.

Many women will benefit from o a procedure called a hysteroscopya thin telescope is used to assess the endometrial cavity, and I tend to carry this out under general anaesthetic.

Over 90 % of women with PMB do not have cancer. Endometrial cancer tends to present early and can be completely cured.

What the cause of post-menopausal bleeding PMB and how is it investigated?

How is postmenopausal bleeding managed?

The development of ultrasound scans, and high-resolution hysteroscopy has radically improved management. The vaginal ultrasound scan will determine endometrial thickness, and any vascular abnormality.

Modern hysteroscopy allows for targeted biopsies. I use the MyoSure for this to ensure targeted biopsies.

I will exclude a gynaecological cancer, and treat the cause; vaginal atrophy with HRT, and polyps with resection.

Postmenopausal Bleeding FAQ's

I have a family history of Lynch syndrome? I have had a bleed what should I do?

Lynch syndrome will put you at a greater risk of developing endometrial cancer. It is important that you are referred to a Gynaecologist for an immediate assessment and scan.

I had a premature menopause, and have frequent vaginal bleeds after sex, and sex is sore. Why is this, and what should I do?

You are a high risk of developing vaginal atrophy. This is why you are sore, and you need treatment with HRT.

I am 60 years old, and have bloody smelly discharge, what should I do?

You need to see a Gynaecologist urgently; you may have a foreign body trapped in your vagina or have a uterine or cervical cancer.

Can HRT cause PMB?

It can and you will benefit from a Gynaecology review to assess your current medication.

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