Publication:

Study of histopathological findings and clinical presentation in post-menopausal bleeding

Background Aim of the research was to study the clinical significance of post-menopausal bleeding in terms of its risk factors, malignancy incidence, and histopathological evaluation for the cause of the post-menopausal bleed.

Methods This prospective observational study was conducted in the department of gynecological in Kanyakumari Government Medical College in 100 post-menopausal bleeding per vaginam. Evaluated by history, clinical examination, and investigations like transvaginal sonography, endometrial biopsy, and cervical biopsy for all subjects, the specimens collected will be sent to the pathology dept for examination and reporting. A total of 17% of patients were observed with an enlarged uterus and 42% scanty uterine curettings.

Results The maximum number of patients, 29%, were reported in the age group of 50 to 55 years with an average age of 54.27 years. Para 2 parity (49%) and body mass index (BMI) value 21 to 30 (60%) were reported maximum in all subjects. Hypertension (17%) was reported as a major risk factor for endometrial carcinoma. Most of the patients were found with simple hyperplasia without atypia 34 (34%), followed by atrophic endometritis 32 (32%), and minimum patients have observed complex hyperplasia with atypia 4 (4%).

Conclusions The symptom indicating endometrial pathology in post-menopausal women is uterine bleeding. The incidence of a malignant cause of post-menopausal bleeding increases as the time lapse between menopause and the onset of bleeding increases. Atrophic endometritis (atrophic vaginitis) was found to be a major cause of post-menopausal bleeding. Post-menopausal hyperplasia carries a more serious threat of cancer than does premenopausal hyperplasia.