Histopathological findings of Post-Menopausal bleeding in Ethiopian women

Abstract

Abstract Background: Postmenopausal bleeding is an alarming sign that may be associated with uterine malignancy. In recent years about 60% of women with post menopausal bleeding are said to have no organic cause in developed countries. There is no data concerning about this issue in Ethiopia. Objective: To determine histopathologic etiology of postmenopausal bleeding. Methods: Retrospective analysis of four years biopsy material from women with postmenopausal bleeding. Results: Four hundred seventy five patients with postmenopausal bleeding were included in the study. Malignant lesions of the genital tract were found in 289 (60.8%) cases. Cervical carcinoma was seen in 245 cases, which accounted for 84.8% of all malignant lesions. Cervical carcinoma was responsible for 51.6% cases of all postmenopausal bleeding patients. Endometrial carcinoma was seen only in 31(10.7%) cases among the malignant cases. In this study underlying cervical malignancy was found in approximately one of every two patients with postmenopausal bleeding. The result of this study doesn't show the dramatic decrease in the prevalence of malignancy as a cause of postmenopausal bleeding seen in Europe and USA. Conclusion: The famous dictum that "Post Menopausal bleeding must be considered as indicative of malignant disease until proven otherwise" still holds true in our circumstance. Priority should be given to introduce a screening method such as cervicography, gynoscopy and pap smear of the cervix to effectively manage gynaecological malignancies in elder women. [Ethiop. J. Health Dev. 2001;15(1):39-44]