J Korean Med Sci.  2017 May;32(5):830-834. 10.3346/jkms.2017.32.5.830.

Common Causes of Postmenopausal Bleeding in Korean Women: 10-Year Outcomes from a Single Medical Center

Affiliations
  • 1Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. tudeolseo@yuhs.ac
  • 2Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Obstetrics and Gynecology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 4Department of Obstetrics and Gynecology, Gil Hospital, Gachon University College of Medicine, Incheon, Korea.
  • 5Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

The common causes of postmenopausal bleeding (PMB), according to the data from the western world, are atrophy, hormone replacement therapy (HRT), endometrial cancer, etc. We conducted a retrospective study to assess whether the causes of PMB in Korean postmenopausal women are similar to those already known. This retrospective study used 10-year medical records (March 2005 to December 2014) of 792 PMB women in the Yonsei University Health System. The data were divided into 2 categories by 5-year intervals to compare the differences between the 2 periods. The most common cause of PMB in Korean women was atrophy (51.1%). Polyps and HRT were the second, followed by anticoagulant medications, cervical cancer, and endometrial cancer. The proportion of patients with cervical cancer significantly decreased during the second half of the decade (8.7% vs. 5.2%; P = 0.048). Although no significant change was noted for HRT, its rank was higher during the latter 5-year period. Only the most common cause of PMB was the same as the conventional data. Interestingly, the proportion of patients with cervical cancer decreased during the latter half of the decade, reflecting the changes in the nation's cancer prevalence rate, while the use of HRT increased.

Keyword

Postmenopausal Bleeding; Common Cause of Postmenopausal Bleeding; Korean Postmenopausal Women; Hormone Replacement Therapy

MeSH Terms

Atrophy
Endometrial Neoplasms
Female
Hemorrhage*
Hormone Replacement Therapy
Humans
Medical Records
Polyps
Prevalence
Retrospective Studies
Uterine Cervical Neoplasms
Western World

Figure

  • Fig. 1 Age-standardized incidence curves of cervical and endometrial cancer, Korea Central Cancer Registry, National Cancer Centr (1213).

  • Fig. 2 Sonographic characteristics of endometrial cancer patients' endometrium.

  • Fig. 3 The percentage change of use of total hormone, ET/EPT, tibolone after publication of WHI results in 2002 (21). ET = estrogen therapy, EPT = estrogen plus progesterone therapy, WHI = post-Women's Health Initiative.


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