Postmenopausal Bleeding

(Bleeding, Postmenopausal; PMB)


Postmenopausal bleeding (PMB) is vaginal bleeding that happens 12 months after a woman’s last menstrual period or in women taking hormone replacement therapy (HRT).

Female Reproductive Organs

Copyright © Nucleus Medical Media, Inc.


Some causes are:

Risk Factors

Some health problems and medicines can raise the risk of this problem.


Vaginal bleeding is a symptom of PMB.


You will be asked about your symptoms and health history. A physical exam will be done. It will include a pelvic exam.

The pelvic organs will need to be viewed. This can be done with:

  • Transvaginal ultrasound
  • Hysteroscopy
  • Saline infusion sonohysterography

Cell and tissue samples will be needed for testing. This can be done with:

  • Endometrial biopsy
  • Cervical cancer screening


Treatment will depend on the cause of the bleeding.


There are no current guidelines to prevent PMB.


The American Congress of Obstetricians and Gynecologists
Office on Women's Health


Society of Obstetricians and Gynaecologists of Canada


Perimenopausal bleeding and bleeding after menopause. The American College of Obstetricians and Gynecologists website. Available at: Updated November 2018. Accessed July 22, 2020.
Postmenopausal bleeding. EBSCO DynaMed website. Available at: Updated February 18, 2019. Accessed July 22, 2020.
Sonohysterography. Radiology Info—Radiological Society of North America website. Available at: Updated February 25, 2018. Accessed July 22, 2020.
Turnbull H, Glover A, et al. Investigation and management of abnormal peri-menopausal bleeding. Menopause Int. 2013 Dec;19(4):147-154.
Last reviewed March 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG
Last Updated: 3/16/2021

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at Our Health Library Support team will respond to your email request within 2 business days.