Prevalence and patterns of post menopausal bleeding at the nnamdi azikiwe university teaching hospital nnewi nigeria - a 5 .pdf

  • G.C Ikpeze
  • I.K Nwaeju
  • N.D Adinma
  • K.E Obi
  • O.Z Ikpeze
Keywords: bleeding, menopausal, women, postmenopausal


To determine the prevalence and
patterns of postmenopausal bleeding.
Materials and methods:
This was a retrospective study
conducted on all the cases of
postmenopausal bleeding managed at
Nnamdi Azikiwe University Teaching
Hospital Nnewi between 1st January
2014 and 31st December 2018. Data
was obtained from the case notes
retrieved from the medical records
department and from gynecological
ward and clinic registers. The
information obtained included age,
parity, year since menopause, history of
hypertension and diabetes mellitus,
time of onset of postmenopausal
bleeding, duration of bleeding, bleeding
frequency, and subjective measurement
of bleeding and histological diagnosis.
Data analysis was done using SPSS
version 21.
Out of the 1640 gynaecological
admissions, 53 were for
postmenopausal bleeding, giving a
prevalence of 3.2% for postmenopausal
bleeding. A total of 46 out of the 53
case files were retrieved from medical,
and were used for further analysis.
Twenty-two (47.8%) were found in
women between the ages of 55 to
65years. The majority of the cases
58.7% were found amongst the
grandmultipara. Majority (82.6%) of the
documented cases, were found in
women who have been menopausal for
at least 12 months and only one case
was reported in women menopausal for
less than 12 months. History of
hypertension and diabetes mellitus were
found in 11 (23.9%) and 7 (15.2%) of the
women respectively. PMB was first
noticed at least 6 months
postmenopausal in 24 (52.3%).
Recurrent PMB was experienced by 38
(82.6 %) of the women in the study
while 3 (6.5%) presented with a single
episode. Subjective estimation of
bleeding revealed that 20 (43.5%) of the
patients used in the study had either
slight or heavy bleeding. Histological
diagnosis showed that squamous cell
carcinoma of the cervix and other
histological types of cervical
malignancies accounted for 12 (26.1%)
and 7 (15.2%) of all histological
diagnoses, respectively.
In conclusion, PMB is a common
gynecological presentation in our
environment. It is closely associated
with diabetes mellitus and hypertension
with the leading cause in our climes
being cervical malignancy which is
largely preventable. Therefore, health
policies should be targeted towards
medical education, lifestyle


1. Choudhary R, Sinha R. A
prospective study on transvaginal
doppler sonography of
endometrium in women with
postmenopausal bleeding. Int J
Med Biomed Stud. 2019;3(11):83-
2. Sreelatha S, Jayanthi SP,
Shivananjaiah C. Postmenopausal
bleeding and its evaluation :
Prospective study in a tertiary care
center. Int J Clin Obstet Gynaecol.
3. Bengtsen MB, Veres K, Nørgaard
M. First-time postmenopausal
bleeding as a clinical marker of
long-term cancer risk : A Danish
Nationwide Cohort Study. Br JCancer. 2019:1-7.
4. Viswanathan M, Daniel S, Shailaja
M, Nazeema A. Socio-Demographic
Profile of Patients with
Postmenopausal Bleeding
Attending Out-Patient Unit of a
Tertiary Care Centre. Sch J Appl
Med Sci. 2014;2:681-684.
5. Piróg M, Kacalska-janssen O,
Bereza T, Jach R. The thin red line –
postmenopausal abnormal uterine
bleeding with endometrial
thickness less than 4 mm. Contemp
Oncol. 2019;23(1):43-46.
6. Ridley-Davies F. Postmenopausal
bleeding. InnovAiT.
7. Stravens M, Short J, Johnson K,
Simcock B, Mcgeoch G, Sykes P.
Management of postmenopausal
bleeding by general practitioners in
a community setting : an
observational study. N Z Med J.
8. Null DB, Weiland CM, Camlibel AR,
et al. Postmenopausal bleeding :
First steps in the workup. J Fam
Pract. 2012;61(10):597-604.
9. Hanegem N Van, Breijer MC,
Slockers SA, Zafarmand MH,
Geomini P, Catshoek R. Diagnostic
workup for postmenopausal
bleeding : a randomised controlled
trial. BJOG. 2016;(November
2014):231-240. doi:10.1111/1471-
10. Behera R, Sahoo R. Evaluation of
postmenopausal bleeding in a
tertiary care hospital. Int J Sci Res.
11. Jadoon S, Khan S, Qadir M, Bibi N.
Postmenopausal bleeding - A
strong indicator of endometrial
carcinoma. Pakistan Armed Forces
Med J. 2019;69(2):368-372.
12. Sert UY, Nas T, Guler I. Frequency
of the Causes of Postmenopausal
Bleeding , Results of a Tertiary
Referral Center in Turkey. Gynecol
Obstet Reprod Med. 2019;25(0):1-
7. doi:10.21613/GORM.2019.1007
13. Kothapally K, Bhashyakarla U.
Postmenopausal bleeding :
clinicopathologic study in a
teaching hospital of Andhra
Pradesh. Int J Reprod
Contraception, Obstet Gynaecol.
14. Ajah LO, Ezeonu PO, Ozonu NC,
Iyoke CA, Nkwo PO, Ajah MI. A Five
Year Review of Cervical Cytology in
Abakaliki, Nigeria. Am J Cancer
Prev. 2015;3(2):23-26.
15. Okunowo A, Alakaloko M,
Ohazurike E, Okunade K. Trend and
characteristics of endometrial
cancer in Lagos, Nigeria. Gulf J
Oncolog. 2019;1(31):52-55.

Journal Identifiers

print ISSN: 2141-162X