Talwar Shailja, Kaur Harpreet, Tapasvi Isha, Nibhoria Sarita, Tapasvi Chaitanya
Department of Obstetrics and Gynecology, Community Health Center, Khamanon, IND.
Department of Obstetrics and Gynecology, Guru Gobind Singh Medical College and Hospital, Faridkot, IND.
Cureus. 2024 Jan 5;16(1):e51690. doi: 10.7759/cureus.51690. eCollection 2024 Jan.
Background Postmenopausal bleeding (PMB) is defined as blood loss from the genital tract occurring 12 months or more after an individual's last menstrual period. It is important for women to recognize abnormal symptoms during menopause, with PMB being one of the most critical. PMB is a common clinical presentation and can be indicative of endometrial carcinoma. A thorough clinical assessment and endometrial histopathology can ensure early diagnosis and treatment of malignancy in high-risk patients. Materials and Methods This study included 120 women with PMB. Their clinical and histopathological characteristics were studied, and correlations between the characteristics were investigated. Patients were evaluated according to their age, parity, duration of menopause, and socioeconomic status. Various comorbidities such as diabetes mellitus, hypertension, and obesity were noted. Results The patients ranged in age from 45 to 80 years, with a mean age of 54.97 ± 5.86 years. Fifty-nine (49.16%) of the patients presented with PMB within 3 years of menopause. PMB was seen most commonly in patients with parity 3, accounting for 37 (30.83%) of the cases. Endometrial thickness was increased in 100 (83.33%) cases. The most common causes of PMB were simple hyperplasia without atypia (SHWOA) in 36 (36%) patients and atrophic endometrium in 14 (14%) patients. Twelve (10%) of the patients had endometrial carcinoma. Benign causes of PMB were present in 91 (75.3%) cases, whereas 29 (24.1%) had a malignant cause. Weakly positive, but significant correlations ( < 0.05) were seen between the development of malignancy and increasing age (Pearson correlation coefficient, r = 0.263) parity (r = 0.244), and body mass index (r = 0.272). Conclusions PMB is considered abnormal. Benign causes are more common, but malignant causes are possible. In the current study, endometrial carcinoma was the most common malignant cause of PMB. Endometrial carcinoma incidence increased with greater endometrial thickness and more years since menopause. Histopathological examination remains the criterion standard for the correct diagnosis. Initiatives are recommended for increasing awareness about PMB to support prompt medical attention for a better prognosis.
绝经后出血（PMB）定义为个体最后一次月经12个月或更长时间后生殖道出现的失血情况。对女性而言，认识绝经期间的异常症状很重要，PMB是其中最关键的症状之一。PMB是一种常见的临床表现，可能提示子宫内膜癌。全面的临床评估和子宫内膜组织病理学检查可确保高危患者恶性肿瘤的早期诊断和治疗。
本研究纳入了120例PMB患者。研究了她们的临床和组织病理学特征，并调查了这些特征之间的相关性。根据患者的年龄、产次、绝经持续时间和社会经济状况对患者进行评估。记录了各种合并症，如糖尿病、高血压和肥胖症。
患者年龄在45至80岁之间，平均年龄为54.97±5.86岁。59例（49.16%）患者在绝经后3年内出现PMB。PMB最常见于产次为3的患者，占37例（30.83%）。子宫内膜厚度增加的有100例（83.33%）。PMB最常见的原因是36例（36%）患者为单纯性增生不伴非典型性（SHWOA），14例（14%）患者为萎缩性子宫内膜。12例（10%）患者患有子宫内膜癌。PMB的良性原因在91例（75.3%）病例中存在，而29例（24.1%）有恶性原因。恶性肿瘤的发生与年龄增长（Pearson相关系数，r = 0.263）、产次（r = 0. .244）和体重指数（r = 0.272）之间存在弱阳性但显著的相关性（< 0.05）。
PMB被认为是异常的。良性原因更为常见，但也可能是恶性原因。在本研究中，子宫内膜癌是PMB最常见的恶性原因。子宫内膜癌的发病率随着子宫内膜厚度增加和绝经时间延长而升高。组织病理学检查仍然是正确诊断的标准。建议采取措施提高对PMB的认识，以支持及时就医以获得更好的预后。
