Associate Professor Bernadette McElhinney explains that abnormal uterine bleeding is a common issue that can affect females throughout their lives. There are various causes of abnormal bleeding, including endometrial polyps, adenomyosis, fibroids, endometrial hyperplasia and malignancy. These conditions can occur in women who are still having periods as well as postmenopausal women.

The perimenopause is a transition period before menopause, characterised by changes in menstrual cycles. It is important to seek medical attention if experiencing postmenopausal bleeding, as it could be a sign of endometrial pathology or cancer. Risk factors for endometrial pathology include increased BMI, PCOS, and certain breast cancer treatments.

Menopausal hormone therapy (MHT) can also cause postmenopausal bleeding, but it can be managed with adjustments to the progesterone component. The gold standard investigation for postmenopausal bleeding is a hysteroscopy and curettage.

Treatment options for abnormal uterine bleeding include medication, progesterone therapy, intrauterine systems and endometrial ablation. It is important to seek medical attention for any changes in bleeding patterns or postmenopausal bleeding, as it could indicate a serious condition.