Vaginal Bleeding - Post Menopausal Bleeding (PMB)

Symptoms: 

Vaginal bleeding is a symptom of PMB. Your doctor can determine what condition is causing the bleeding and whether it is serious. If you have PMB, you should see your doctor.

Tests to diagnose: 
  • An ultrasound of your pelvis to get a picture of your cervix, uterus, endometrium and ovaries. An external ultrasound is a small hand held device (called a transducer) that the doctor will move over you belly. An internal ultrasound is a small wand that the doctor inserts into your vagina to get a better image of your cervix and uterus.
  • A pipelle test to take and test a sample or biopsy of your endometrium. This can be done without anaesthetic in a day clinic with a thin tube (or pipelle) which is put into your uterus (through your vagina) and gently sucks up a small sample of cells.
  • A hysteroscopy to take photos of your cervix, uterus and endometrium. A sample or biopsy of your endometrium may also be taken for testing.  A hysteroscopy involves putting a long, narrow instrument (called a hysteroscope) into your uterus through your vagina.  It can be done under local or general anaesthetic.
  • A dilation and curette (D&C) to scrape away part of your endometrium and test it. This is done under a general anaesthetic.
Treatment: 

The kind of treatment you have will depend on what is causing the bleeding.

  • Atrophic vaginitis and thinning of the endometrium are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft flexible ring which is put inside your vagina and slowly releases the medication.
  • Polyps are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anesthetic or you may need to go to hospital to have a general anesthetic.
  • Thickening of the endometrium is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.