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Postmenopausal Bleeding from Atrophic Endometrium

Histologic and quantitative examinations of myometrial arterioles and an evaluation of the clinical status of 37 women with unexplained postmenopausal bleeding and 40 control women with atrophic endometrium were done to determine if uterine bleeding might be secondary to myometrial arteriolar disease. Clinical evidence of systemic vascular disease and hypertension was significantly more frequent in patients with postmenopausal bleeding than in the control groups. Myometrial arteriolosclerosis was not as prevalent among older patients as it was in the younger group of bleeding patients who did not have severe uterine prolapse or atrophic endometrial cysts. Severe uterine prolapse or atrophic endometrial cysts, or both, were of greater etiologic significance in the older group of patients with unexplained postmenopausal bleeding from the atrophic endometrium than in the younger group.