Vaginal bleeding with lower abdominal pain and breast distension after menopause should exclude endometrial cancer, cervical cancer, ovarian tumor with secretion function and other diseases. 1. Endometrial cancer: the main symptoms are vaginal bleeding, vaginal discharge and lower abdominal pain in menopausal women or perimenopausal women; if transvaginal ultrasound shows that the endometrium is more than 4mm, high attention should be paid to it, and hysteroscopy should be perfected if necessary. 2. Cervical cancer: postmenopausal women may also present with vaginal bleeding, which can be excluded by cervical liquid-based cytology screening combined with human papilloma virus screening. 3. Ovarian tumors with endocrine function: certain gonadal mesenchymal stromal cell tumors can secrete estrogen, which leads to the increase of estrogen level in the body and promotes the proliferation of endometrial lining, resulting in endometrial exfoliation and vaginal bleeding, which may be accompanied by lower abdominal pain, breast swelling and pain, and other discomforts. Under normal circumstances, occasional menstrual flow within one year after menopause may be a normal phenomenon, because there is a process of ovarian function decline, but for menopause for more than 2 years, suddenly accompanied by menstrual flow, should be examined to clarify whether there is the possibility of malignant lesions. Postmenopausal vaginal bleeding is an important sign of abnormality in postmenopausal women. Once it occurs, the gynecological clinic should be consulted in time to identify the cause of the disease and treat the symptoms.
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