Abstract: Background: Postmenopausal bleeding (PMB) is a common clinical problem. Patients with PMB have 10%–15% chance of having endometrial carcinoma and therefore the diagnostic workup is aimed at excluding malignancy. Transvaginal sonography (TVS) is used as a first step in the diagnostic workup, but different authors have come to different conclusions assessing the accuracy of TVS for excluding endometrial carcinoma. Diagnostic procedures obtaining material for histological assessment (e.g., dilatation and curettage, hysteroscopy, and endometrial biopsy) can be more accurate but are also more invasive. The best diagnostic strategy for diagnosing endometrial carcinoma in patients with PMB still remains controversial. Future research should be focussed on achieving a higher accuracy of different diagnostic strategies.
Objective: Aim of this study is to evaluate women with post-menopausal bleeding in terms of etiology, risk factor and most common cause of post-menopausal bleeding.
Method: Prospective study of 150 patients over 2years with post-menopausal bleeding evaluated by TVS, endometrial biopsy, per speculum and cervical biopsy for mass.
Univariate and multivariate logistic regression identified factors associated with risks of endometrial hyperplasia.
Result
1.In this study mean age at presentation was 59.7yr
2.Mean ET was 6.7mm
3.HPE was s/o atrophic endometrium 2.3%, endometrial hyperplasia 6.4%, ca endometrium12.2%, proliferative endometrium 9.4%, endometrial polyp 2.9%. ca cervix 39.5%.
4.Using multivariate logistic regression, we found that ET, recurrent heavy menstrual bleeding, diabetes mellitus, obesity were better predictiors of endometrial cancer.
5.Most common cause of post-menopausal bleeding in India is ca cervix with histopathology of squamous cell cancer being more common.
Conclusion: The postmenopausal bleeding is an important symptom and requires careful and timely assessment to eliminate the possibility of malignancy as soon as possible.
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