At present, we often meet patients with postmenopausal bleeding in the clinic and constantly ask what is going on. Do I need to treat it? My answer is that postmenopausal bleeding should neither be taken lightly nor intimidated by it, but should be seen in a hospital. Various pathologies should be excluded and symptomatic treatment should be given for various causes. So, what is postmenopausal bleeding? When there is a period of one year after the last menstruation and no more menstruation, then the last menstruation is called menopause. Postmenopausal bleeding is a clinical symptom and is one of the common gynecological symptoms in older women. It can be caused by many reasons, mostly benign diseases, but it is also an early sign of some malignant tumors and, therefore, should not be ignored. What are the most common causes of postmenopausal bleeding include? First of all, there is a part of women who occasionally bleed a small amount of vaginal bleeding for 2-3 years after menopause, or the manifestation of breast swelling and pain, especially women who have taken health supplements or medications to prevent aging are prone to this, which is due to the accumulation of a small amount of estrogen, which stimulates the endometrium, resulting in the shedding of the endometrium, and the bleeding stops after discontinuation. In some other cases, after menopause, the estrogen level decreases, the resistance of the vaginal mucosa decreases, atrophy occurs, inflammation occurs, and there can also be a bloody vaginal discharge. Or, there are small fibroids that grow close to the endometrium and a small amount of bleeding can occur. There are also some older women with declining function of the supporting tissues of the uterus, flaccidity, prolapse of the uterus, and frequent rubbing of the cervix by underwear, causing erosion, which can also cause bleeding. These are all benign lesions and there is nothing to fear. Secondly, people with high risk factors such as hypertension, diabetes, obesity, or those with family history of cancer are the high risk group of endometrial cancer. This group is prone to endometrial thickening, hyperplasia, endometrial polyps and also postmenopausal bleeding. If no attention is paid and the endometrium overgrows or even atypical hyperplasia, then it is precancerous lesion. Third, cervical lesions cause postmenopausal bleeding. Cervical polyps and cervicitis are also common causes of postmenopausal bleeding. Cervical cancer is a malignant tumor and the earliest manifestation is also vaginal bleeding or bleeding after sexual intercourse. Of course, there are other manifestations of cervical cancer such as vaginal bleeding and increased leucorrhea. Fourth, ovarian tumors can also cause postmenopausal bleeding. In particular, tumors that secrete hormones can also cause postmenopausal bleeding. Nowadays, as people pay more attention to health care, most of them will come to the hospital once they have postmenopausal bleeding. There are many ways to diagnose, such as screening for cervical cancer by cervical smear or liquid-based thin layer cell (TCT) examination or human papilloma virus (HPV) test, detecting pelvic and abdominal tumors by ultrasound, and diagnosing endometrial thickening (usually the thickness of endometrium after menopause does not exceed 4 mm), intrauterine lesions can be detected by hysteroscopy, and precancerous lesions can be detected by hysteroscopic biopsy if necessary. Therefore, it is essential for every woman to have an annual gynecological checkup. In fact, for most of the general public, rural women, especially some women in remote mountainous areas, they almost never see a gynecologist after giving birth to a child. Therefore, for this group of people, once they have a disease, the condition is often already very serious. Recently we met a 57-year-old woman, 5 years after menopause, who had irregular vaginal bleeding in September last year, thought she had her period again and didn’t pay attention to it. A hysteroscopy was performed to take a biopsy and the pathological diagnosis was endometrial cancer. The surgery had just been done. For older women, how to detect the early signs of women’s diseases? 1.Abnormal leucorrhea: increased leucorrhea, watery leucorrhea, rice soup-like or slop-like leucorrhea, pus and blood leucorrhea. 2, bleeding: vaginal bleeding after menopause, or fresh blood or old blood or dropping out rotten flesh-like tissue should be alert. 3, mass: unexplained thickening of the waist, or a mass felt in the abdomen, should always go to the hospital. Finally, talk about health care for older women. Postmenopausal women, due to the decline of hormone levels, will have corresponding complications. Such as menopausal symptoms, irritability, hot flashes, poor sleep quality, atrophy of reproductive organs performance, vulva dryness, unsatisfactory sex life, frequent urinary tract infections, vaginitis, in addition, the emergence of osteoporosis, prone to bone and joint pain. Therefore, one should maintain a good state of mind, communicate with peers frequently, participate in more outdoor fitness activities, and take appropriate calcium supplements to prevent osteoporosis. In addition, after entering menopause, women’s sexual arousal and sexual response will become slower. At this time, you can extend the induction time and increase verbal stimulation; or use some lubricants to protect the vaginal mucosa. Husbands learn to be considerate and wives should not refuse. With proper handling, sex can even slow down some symptoms of menopause and stabilize women’s emotions. In conclusion, as human life expectancy increases, health care for older women is sure to attract wider attention. As protectors of human health, we will definitely use what we have learned to better protect women’s health.