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Introduction

Postmenopausal bleeding (PMB) is defined as any vaginal bleeding occurring more than 12 months after the cessation of menses.  Approximately 5%-10% of women experience PMB, which can range from a single bleeding episode to daily vaginal bleeding.  PMB can occur due to a variety of conditions, many of which are benign, but it is also a common presentation of endometrial cancer.  Therefore, all patients presenting with PMB require a thorough evaluation.

Etiologies

Although PMB is mostly of uterine origin, it can also occur due to bleeding from other locations in the urogenital tract (eg, vulva, urethra, cervix).  The source of bleeding can be divided into nonuterine etiologies, uterine structural etiologies, and uterine nonstructural etiologies (with an emphasis on endometrial hyperplasia and cancer).

Nonuterine etiologies

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