Abstract:

Postmenopausal bleeding (PMB) is a common gynecological symptom in postmenopausal women, harboring dual risks of benign and malignant lesions, making it a critical focus in the health management of postmenopausal females. Ovarian failure in postmenopausal women leads to estrogen deficiency, subsequently triggering a series of degenerative changes in the reproductive system. Considering the pathophysiological characteristics unique to the postmenopausal period, the etiologies of PMB can be primarily categorized as reproductive system inflammation, benign lesions, neoplasms, ovarian endocrine dysfunction, drugs and supplements, trauma and foreign bodies, and systemic diseases. In clinical practice, the diagnosis of PMB requires combining a detailed medical history, comprehensive physical examination, and targeted ancillary investigations, prioritizing the exclusion of malignant lesions while differentiating benign causes to ensure diagnostic accuracy. The management of PMB relies on a definitive etiological diagnosis, comprehensively considering the patient's individual circumstances, clinical characteristics, and treatment preferences. Standardized and individualized treatments are implemented according to different etiologies, including pharmacotherapy, surgical intervention, radiotherapy, Traditional Chinese medicine adjuvant therapy, and lifestyle modifications.

Key words: Postmenopause, Metrorrhagia, Diagnosis, Therapy, Pathophysiological changes, Etiology and pathogenesis