Aetiology of postmenopausal bleeding.

A retrospective analysis has been made of 160 cases of postmenopausal bleeding. The women were at least 45 years old and the time lapse from the last menstruation was at least 2 years. The cause was a malignant neoplasm in 23·75%. The incidence of malignancy showed a definite rise with advancing age and with increasing duration of bleeding. It was nearly twice as high in women who stopped menstruation after the age of 55 years. Malignancy also seemed to be more frequent in patients with profuse bleeding and in those who had amenorrhoea lasting for 20 years or more. The most usual malignant lesions were endometrial and cervical carcinoma, the ratio of these two conditions being 1·6: 1. Oestrogen administration was the most common cause in the non-malignant group: 12·5%. No cause for bleeding could be demonstrated in 8·8%. The aetiology of postmenopausal bleeding is discussed.