Post-menopausal bleeding (PMB) refers to any vaginal bleeding occurring more than 12 months after menopause and is always considered abnormal. Common causes include thinning of the uterine or vaginal lining (atrophy), benign polyps, hormonal therapy, or more serious conditions like endometrial hyperplasia or cancer. Other potential causes include infections, trauma, or the use of foreign objects like vaginal pessaries. Even light spotting or pink-brown discharge warrants prompt evaluation to rule out serious underlying conditions.

Diagnostic investigations for PMB typically include a pelvic exam, transvaginal ultrasound to assess the uterine lining, and an endometrial biopsy to check for abnormal or cancerous cells. Depending on the findings, treatment options range from vaginal estrogen for atrophic changes to surgical removal of polyps or more extensive procedures for precancerous or cancerous conditions. Early detection and management are essential for addressing the root cause and ensuring long-term health.