**Core Concept:** Post-menopausal bleeding is a condition characterized by the occurrence of bleeding in women who have completed menopause. In post-menopausal women, the most common cause of bleeding is hormonal imbalance due to the absence of estrogen and progesterone production.

**Why the Correct Answer is Right:** The correct answer (B) states that post-menopausal bleeding is not associated with pregnancy. During pregnancy, the normal physiological changes lead to increased hormonal activity, including estrogen and progesterone production, which is different from the hormonal imbalance seen in post-menopausal women.

**Why Each Wrong Option is Incorrect:**

A. Post-menopausal bleeding can be associated with hormonal imbalances, making this option incorrect.
C. While post-menopausal bleeding is usually caused by hormonal imbalance, it can be a presenting symptom of underlying conditions (e.g., uterine or ovarian pathology). However, the focus of this question is on the association with pregnancy, making this option incorrect.
D. Post-menopausal bleeding may be caused by hormonal imbalance, but it is not specific to pregnancy, making this option incorrect.

**Clinical Pearl:** A thorough history and examination are essential in determining the cause of post-menopausal bleeding, as it may be a presenting symptom of various underlying conditions. A correct diagnosis requires considering both hormonal causes and potential associations with other conditions.