What is postmenopausal vaginal bleeding? The average age of menopause for women in China is 49 years old, and amenorrhea for more than one year is called menopause. When vaginal bleeding occurs again after menopause, it is called postmenopausal bleeding, which is commonly known as “reverse blossoming”. What are the possible diseases associated with postmenopausal vaginal bleeding? What tests are needed? Common benign diseases: senile vaginitis, cervical polyps, endometrial polyps, submucosal fibroids, urethral meatus, intrauterine device not removed for a long time after menopause, endometrial hyperplasia and functional changes caused by hormone replacement therapy, etc.; common malignant diseases: endometrial cancer, cervical cancer, ovarian cancer, etc.; among them, endometrial cancer accounts for about 80% of postmenopausal bleeding. The older the age, the longer the time of menopause, the more the bleeding time and the bleeding volume, the higher the possibility of malignancy. Items to be examined: vaginal examination, white belt routine, TCT+HPV, vaginal ultrasound, hysteroscopy. What are the advantages and disadvantages of vaginal ultrasound and hysteroscopy? Vaginal ultrasound: easy to perform, time saving, no pain, no anesthesia, high sensitivity, low cost. Postmenopausal endometrium >4mm indicates endometrial abnormalities. It is highly sensitive to detect endometrial mass lesions, but not specific and cannot identify small endometrial lesions or submucosal masses. Hysteroscopy: With advanced hysteroscopic equipment and miniaturization of the mirror, outpatient hysteroscopy is easy to perform, safe and reliable. It can clarify the nature of lesions in the uterine cavity that are abnormal or uncertain with ultrasound images, such as benign diseases like submucosal fibroids and endometrial polyps. Hysteroscopy can also be performed with microscopic biopsy to exclude or confirm the diagnosis of malignant lesions or precancerous lesions. The cost is higher than vaginal ultrasound. Why should postmenopausal vaginal bleeding be taken seriously? Postmenopausal vaginal bleeding is not a disease, but a clinical symptom that is often an early sign of a disease or a precursor to a serious illness. The key for patients with postmenopausal vaginal bleeding is early detection, early diagnosis and early treatment. Once postmenopausal vaginal bleeding occurs, you should not take it lightly and go to the hospital in time to confirm the disease through vaginal examination, vaginal ultrasound, hysteroscopy, etc. and take appropriate treatment measures as soon as possible.