What are the most common causes of vaginal bleeding in a postmenopausal woman?
In postmenopausal women, atrophy of the endometrium is the most common etiology of vaginal bleeding. Other common causes include endometrial polyps, endometrial hyperplasia, and endometrial cancer. Less common etiologies include uterine leiomyomas, adenomyosis, hormone replacement therapy, and cervical cancer. Approximately 12% of women with postmenopausal bleeding have endometrial cancer. Endometrial cancer is one of the most common gynecologic malignancies, and the risk of development increases with age.