Nagina Fatima Liaquat, Khurshid Noorani.
Causes of Post-Menopausal Bleeding - A Study of 328 cases.
J Coll Physicians Surg Pak Jan ;10(4):134-7.

A study of consecutive 328 patients with complaints of post-menopausal bleeding was carried out during May 1988 to April 1998 in the Department of Gynaecology and Obstetrics, Jinnah Postgraduate Medical Centre, Karachi, to find out etiological factors responsible for postmenopausal bleeding. The women using hormone replacement therapy were not included in the study. Malignancy was the most common cause (76%) among patients between 66-85 years age. Carcinoma of cervix was found in 39.6%, carcinoma of endometrium in 10.6%, polyp in 11.8%, chronic cervicitis in 8.8%, atrophic endometrium in 7.1%, endometri- hyperplasia in 5.4%, senile vaginitis in 3.6%, liomyoma in 3.2%, carcinoma of vulva in 1.2%, carcinoma of vagina 0.9%, ovarian carcinoma in 0.6% and forgotten IUCD, liomyosarcoma, mixed mullarian mesenchymal tumour of uterus each in 0.32% of cases. Five cases were due to trauma of which four were due to coital trauma and one due to accidental trauma. Etiology remained undetermined in 4.6% of cases. The most common cause of post-menopausal bleeding in our study was carcinoma of cervix. Screening programme for early detection of carcinoma of cervix at a pre-invasive stage is recommended.

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