ABSTRACT
Uterine polyps are a common cause of postmenopausal bleeding. Any vaginal bleeding that occurs after 6 months of amenorrhoea from presumed menopause should be treated as suspicious. Investigations should be directed to determine the cause of bleeding depending on the age of the woman. Atrophic vaginitis is caused by non-specific vaginal irritation and extreme thinning of vaginal epithelium as a result of oestrogen deficiency. Because of atrophic changes, even the slightest of trauma from intercourse or dabbing oneself dry may result in bleeding. Endometrial inflammation and thinning that occurs as a result of oestrogen deficiency is known as atrophic endometritis. It may result in postmenopausal spotting or even bleeding, particularly in hypertensive women. Endometrial polyps are usually inflammatory, but may occasionally have hyperplastic or neoplastic changes of the covering endometrium. Uterine polyps can also be of fibroid origin and are much more common in a fibroid uterus, though they rarely become sarcomatous.
