What could be the cause of vaginal bleeding after the menopause - PMB?

What could be the cause of vaginal bleeding after the menopause - PMB?

In 90% of cases examination and investigation will find either no obvious cause or an innocent one. The commonest innocent cause is atrophic vaginitis. Cervical and endometrial polyps (cervical polyps) are further common findings and they are usually benign. Occasionally cancer of the endometrium (uterus) or cervix may be found - about 10-25% being quoted.

Women frequently present to their gynaecologist with a period-like bleed when they have previously fulfilled the criteria for the menopause. Premenstrual type symptoms such as breast discomfort may have preceded the bleeding. Appropriate clinical examination and investigation is imperative. Once a pathological (disease) cause for the bleeding has been excluded, it would seem logical to conclude that the woman might have been correct in her belief that she had experienced menstruation again. Presumably this must have followed maturation of an egg which was scheduled to occur a year or more after the previous period (Q 2.3).

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