Menstrual disorders and postmenopausal bleeding in women between 40 and 59 years

Abstract

Introduction: Abnormal uterine bleeding in middle-aged women is a health problem.
Objective: To characterize middle-aged women with menstrual disorders and postmenopausal bleeding in the outpatient clinic of the Ramón González Coro Gynecology-Obstetric Hospital during the period from January 2017 to December 2020.
Methods: A descriptive and cross-sectional study of 200 patients between 40 and 59 years of age who attended the climacteric and menopause clinic for presenting menstrual disorders and/or postmenopausal bleeding was conducted.
Results: In perimenopausal women, the most frequent menstrual disorders were hyperpolymenorrhea, amenorrhea, and metrorrhagia; 81.9% of them did not show alterations in the gynecological examination. Postmenopausal women presented bleeding in a late stage, predominantly alterations of the middle compartment and vaginal atrophy. In perimenopausal women, proliferative endometrium and secretory endometrium predominated as diagnoses. In postmenopausal women, endometrial polyps and atrophic endometrium predominated as the cause of bleeding. Watchful waiting was frequently used in perimenopause and in postmenopausal women, in addition to surgical treatment and polyp excision in postmenopausal women.
Conclusions: Women with perimenopause were younger, hyperpolymenorrhea and amenorrhea with vasomotor symptoms predominated, postmenopausal bleeding prevailed due to endometrial polyps and endometrial atrophy, expectant management was used more frequently.