Evaluation of Clinical Significance and Endometrial Pathology in Patients with Postmenopausal Bleeding in a Tertiary Care Center

Background: Postmenopausal bleeding is frequent in gynecology and occurs approximately in 5% to 10% of postmenopausal women. But most of the causes of post-menopausal bleeding are benign and treated conservatively. Women with postmenopausal bleeding have a primary or secondary malignancy of about 10%. So before starting treatment malignancy must be excluded. Common malignancies among them are endometrial or cervical carcinoma and rarely, ovarian cancer. The incidence of malignancy in the postmenopausal period remains sufficiently high, so it requires immediate investigations for early diagnosis, prompt treatment, and vigilant follow-up. The aim of this study is to investigate the clinical significance and endometrial pathology in patients with PMB. Methods: This retrospective study was conducted in Department of Obstetrics and Gynaecology, ESIC Medical College and Hospital, Bihta, Patna from January 2024 to June 2024. About 80 patients with PMB were selected and these patients were evaluated by pelvic USG, Endometrial biopsy and endometrial histopathology. Data were analyzed using MS office 2019. Results: Maximum patients with PMB belonged to age group of 46-50 years (31.25%). 57.5% were multiparous (parity>2). About 53.75% had PMB 1 to 5 years after menopause. Endometrial thickness (ET) was > 4mm in 86.25%. Majority had ET between 5-10mm (58.75%). Histopathological analysis of endometrial curettings showed Proliferative phase in 35%, disordered proliferative phase in 17.5%, Atrophic Endometrium in 13.75% and endometrial carcinoma in 11.25%. Conclusion: Postmenopausal bleeding is an important symptom which requires evaluation to eliminate possibility of malignancy. Transvaginal sonography (TVS) is the first mode of investigation for PMB but Histopathology of Endometrium serves as gold standard for definitive diagnosis.