Assessment of postmenopausal bleeding: a cohort case study

Abstract

The objective of this study is to assessment the postmenopausal bleeding (PMB), and investigated their causes, correlation with variable socio-demographic status. A 140-women complaining of PMB were enrolled in this study, each patient had a proper questionnaire filled in, with appropriate investigations that included; ultrasonography, Pap smear, colposcopy with cervical biopsy and endometrial curettage to take endometrial biopsy for histopathology. Nearly all cases were married 135 (96.4%), most of them were obese and overweight 97(69.3%), 43(30.7%) were having normal body mass index. Various etiology of PMB were found in this study; endometrial cancer (9.3%), cervical cancer (0.7%), atrophic endometritis (7.1%), atrophic vaginitis (2.8%), endometrial hyperplasia (45%), Cervicitis-CIN (15.7%), cervical polyp (12.8%), and endometrial polyp (18.6%). Bleeding from benign causes and of endometrial cancer occurs at fifth decade and sixth decade of life, while from cervical cancer occurs at seventh decade. The pattern of PMB; mild bleeding significantly higher in cervicitis-CIN; moderate bleeding more in endometrial polyp and significantly higher than mild and sever bleeding; while severe bleeding was significantly associated in endometrial cancer. Duration of PMB had a vast range (4 days to 5 years). 24.83% of cases had prolonged bleeding > 6months, (48.7%) with endometrial hyperplasia, (12.8%) had endometrial cancer. The endometrial cancer present in 10% of the patients with recurrent PMB.