DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20210008

A two-year study on postmenopausal bleeding at a tertiary institute

Sowmyanarayanan Lavanya, Swetha Munivenkatappa, Anthata Jyothsna Sravanthi

Abstract


Background: The life expectancy of women shows an increase as a result of which women experience a long postmenopausal phase. Postmenopausal bleeding is a worrisome symptom occurring in 10 % of the women, making them seek a gynaecology opinion at the earliest. Women in developed countries have a predilection for developing endometrial cancer whereas cancer cervix still dominates in the developing countries. This prospective study was carried out on 75 women presenting with postmenopausal bleeding to the gynaecology clinic at a tertiary hospital set up. The study aimed to find the incidence of postmenopausal bleeding, age distribution, causes and different evaluation methods to confirm the diagnosis.

Methods: The present study is a prospective study conducted on 75 postmenopausal women reporting with postmenopausal bleeding at the gynaecology clinic at a tertiary care hospital.              

Results: Menopause was noted above 45 years in 84% of the patients and 16% were in 40-45 years age. Postmenopausal bleeding was observed in 50-60 years in 56% of women and 30% above 60 years. The medical problems associated were hypertension (20%), diabetes (11%), obesity (22%), hypothyroidism (4%). 53 women had benign causes while 22 had malignancy.

Conclusions: Benign lesions of the genital tract are common causes of postmenopausal bleeding. Carcinoma cervix and endometrium classically present with postmenopausal bleed. Strong suspicion, thorough evaluation and early diagnosis improve the quality of life and reduce the morbidity and mortality.


Keywords


Postmenopausal bleeding, Carcinoma cervix, Carcinoma endometrium, Endometrial thickness, Endometrial polyp

Full Text:

PDF

References


Kothapally K, Bhashyakarla U. Postmenopausal bleeding: clinicopathological study in a teaching hospital of Andhra Pradesh: Int J Reprod Contracept Obstet Gynecol. 2013; 2(3):344-8.

Ubeja A, Singh A. Clinicopathological evaluation of postmenopausal bleeding in rural hospital set up. Int J Reprod Contracept Obstet Gynecol. 2017;6:3556-9.

Mittra I, Mishra GA, Singh S, Aranke S, Notani P, Badwe R, et al. A cluster randomized, controlled trial of breast and cervix cancer screening in Mumbai, India: Methodology and interim results after three rounds of screening. Int J Cancer. 2010;126:976-84.

Gandi SR, Vishwekar PS. A study on correlation of Pap smear, colposcopy and colposcopic directed biopsy in women with unhealthy cervix. J Evolution Med Dent Sci. 2017;6(7):515-18.

Sharma DD, Chandnani KA. A study of, etiology and prevalence of malignancy in patients with postmenopausal bleeding. Int J Reproduct Contracept Obstet Gynecol. 2017;6:3973-8.

Breijer MC, Timmermans A, van Doorn HC, Mol BW, Opmeer BC. Diagnostic strategies for postmenopausal bleeding. Obstet Gynecol Int. 2010;2010:850812

Kaur M, Singh R, Sharma M. Endovaginal sonographic evaluation of postmenopausal uterine bleeding. J Clinic Diagnost Res. 2010;(4):2175-82.

Kolhe PS. Management of abnormal uterine bleeding e focus on ambulatory hysteroscopy. Int J Womens Heal. 2018;10:127e36.

Spiezio Sardo ADS, Calagna G, Carloa CD. Tips and tricks in office hysteroscopy. Gynecol Minim Invasive Ther. 2015;4(1):3e7.

Karmakar PJ, Wilkinson A, Rathod M. Histopathological evaluation of postmenopausal bleeding. IOSR J Dent Med Sci. 2014;13:53-7.

Mallick A, Behera R, Subudhi K. Histopathological study of endometrium in postmenopausal bleeding. J Evol Med Dent Sci. 2013;2:9010-8.

Aswathy S, Quereshi MA, Kurian B, Leelamoni K. Cervical cancer screening: Current knowledge and practice among women in a rural population of Kerala, India. Indian J Med Res. 2012;136:205-10.

Harsha Kumar H, Tanya S. A study on knowledge and screening for cervical cancer among women in Mangalore city. Ann Med Health Sci Res. 2014;4:751-6.

Nirupama V, Suneetha Y, Prabha Devi K. PostMenopausal Bleeding: An Analytic Study of 100 Cases. Int J Sci Res. 2015:4:2319.

Sonali Rathi, Sangeeta K, Manisha K. Histopathological evaluation in women with Postmenopausal Bleeding and Associated Risk factors for Endometrial Carcinoma. J Evolut Medic Dent Sci. 2013;2(24):4397-402.

Arati Mallick, Ritanjali Behera, Khetrabasi Subudhi. Histopathological study of endometrium inpostmenopausal bleeding. Journal of Evolution of Medical and Dental Sciences. 2013;2(46):9010-8.

Van den Bosch T, Ameye L, Van Schoubroeck D, et al. Intracavitary uterine pathology in women with abnormal uterine bleeding: a prospective study of 1220 women. Facts Views Vis Obgyn. 2015;7(1):17–24.

Karmarkar PJ, Wilkinson A, Rathod M. Histopathological evaluation of postmenopausal bleeding. J Dent Medic Sci. 2014;13(10):53-7.