• Postmenopausal Bleeding

    (Bleeding, Postmenopausal; PMB)


    Postmenopausal bleeding (PMB) is bleeding from the vagina that happens after a woman has stopped having regular menstrual periods because of menopause. Any vaginal bleeding that occurs 12 months after a woman’s last menstrual period is considered PMB.
    Female Reproductive Organs
    Copyright © Nucleus Medical Media, Inc.


    PMB may be caused by several factors. These may include:
    • Continuous hormone replacement therapy (HRT)
    • Thinning and loss of elasticity of the vagina
    • Inflammation of the endometrium, the lining of the uterus
    • Endometrial hyperplasia, a thickening of endometrium
    • Polyps, noncancerous growths on the uterus or cervix
    • Infection of the uterus or cervix
    • Endometrial cancer
    • Cervical cancer
    • Fibroid tumors in the uterus or vagina

    Risk Factors

    Some medical conditions and medications you take can increase your chances of having PMB.


    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.


    You will be asked about your symptoms and medical history. A physical exam will be done.
    Tests will be done to find the cause of the bleeding. Tests include:
    Your doctor may need cell and tissue samples. This can be done with:
    • Cervical cancer screening
    • Endometrial biopsy


    Talk with your doctor about the best treatment plan for you. The first priority is ruling out cancer. Treatment will depend on the findings of your tests and the cause of the bleeding. For instance, if your tests show signs of cancer, you will be referred to an oncologist, a doctor who specializes in treating cancer.


    There are no current guidelines to prevent PMB.


    American Congress of Obstetricians and Gynecologists http://www.acog.org

    Office on Women's Health http://www.womenshealth.gov


    Health Canada http://www.hc-sc.gc.ca

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org


    American Congress of Obstetricians and Gynecologists (ACOG) Committee Opinion on role of transvaginal ultrasonography in evaluation of postmenopausal bleeding. Obstet Gynecol. 2009;113(2):462.

    Gale A, Dey P. Postmenopausal bleeding. Menopause Int. 2009;15(4):160-164.

    Perimenopausal bleeding and bleeding after menopause. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq162.pdf?dmc=1&ts=20121221T1430328285. Updated May 2011. Accessed March 18, 2014.

    Postmenopausal bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 17, 2012. Accessed March 18, 2014.

    Sonohysterography. Radiological Society of North America Radiology Info website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=hysterosono. Updated July 16, 2013. Accessed March 18, 2014.

    11/5/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Khati NJ, Glanc P, et al. ACR Appropriateness Criteria abnormal vaginal bleeding [online publication]. Reston (VA: American College of Radiology (ACR); 2014. 13 p. Available at: https://acsearch.acr.org/docs/69458/Narrative. Accessed November 5, 2014.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.