Bleeding After Menopause: How To Get A Diagnosis
No matter the cause of your postmenopausal bleeding, its important to visit the doctor. In most cases, this symptom is caused by a minor condition however, all possible causes must be ruled out. There are several different tests and/or procedures your doctor might recommend to discover the cause of postmenopausal bleeding.
How Do I Manage Bleeding After Menopause
Your doctor will want to do some investigations to find the cause of your bleeding. Let them know if you have noticed any changes going to the toilet, whether you have pain, have lost weight or whether you are on HRT. You may also want to check whether you need a cervical screening test.
Some women may need to have an ultrasound, blood test or may be referred to a gynaecologist for further tests.
Treatment will depend on what is causing the bleeding. It may involve medicines to control problems with the lining of the uterus, or surgery to remove polyps.
What Are The Types Of Endometrial Hyperplasia
Doctors classify endometrial hyperplasia based on the kinds of cell changes in the endometrial lining. Types of endometrial hyperplasia include:
- Simple endometrial hyperplasia : This type of endometrial hyperplasia has normal-looking cells that arent likely to become cancerous. This condition may improve without treatment. Hormone therapy helps in some cases.
- Simple or complex atypical endometrial hyperplasia: An overgrowth of abnormal cells causes this precancerous condition. Without treatment, your risk of endometrial or uterine cancer increases.
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What Should Be Done For Post
Treatment depends on the cause of your postmenopausal bleeding. If you have polyps, you may need surgery to remove them. Endometrial atrophy can be treated with medicines. Endometrial hyperplasia may be treated with progestin hormone therapy. Surgery to remove your uterus will be needed if you have endometrial or uterine cancer.
What Causes Endometrial Hyperplasia
Women who develop endometrial hyperplasia produce too much estrogen and not enough progesterone. These female hormones play essential roles in menstruation and pregnancy. During ovulation, estrogen thickens the endometrium, while progesterone prepares the uterus for pregnancy. If conception doesnt occur, progesterone levels drop. The progesterone drop triggers the uterus to shed its lining as a menstrual period.
Women who have endometrial hyperplasia make little, if any, progesterone. As a result, the uterus doesnt shed the endometrial lining. Instead, the lining continues to grow and thicken.
Additionally, obesity contributes to the elevation of estrogen levels. The adipose tissue can convert the fat producing hormones to estrogen. This is the how obesity contributes to elevated circulating levels of estrogen and increases the risk of endometrial hyperplasia.
The Diagnostic Process May Involve Multiple Steps
Even though postmenopausal bleeding can have a number of different causes, your doctors first objective is to rule out potential cancers.
Well usually do a physical exam to look for blood or masses, such as fibroids, followed by an ultrasound to see how thick a patients uterine lining is, Mantia-Smaldone explained. A postmenopausal womans uterine lining should be quite thin, since she isnt menstruating.
Endometrial cancer can cause the lining of the uterus to thicken. If your uterine lining appears thicker than normal, your doctor will recommend a biopsy, in which a sample of your uterine lining is removed and examined under a microscope.
What Should I Know About Post
Vaginal bleeding after menopause: main causes Endometrial atrophy. The endometrium is the innermost layer that covers your uterus. Endometrial hyperplasia. This condition is the opposite of endometrial atrophy. Polyps. Polyps are non-cancerous tissue growths that usually attach to the uterine wall and develop from the endometrium. Vaginal atrophy. Cancer.
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What Symptoms Should I Watch For Between Pap Smears
Pre-cancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap smear are usually required.
When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching . Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms can be caused by other conditions and are not sure signs of cancer but be sure to see your doctor if any of these symptoms occur.
Rare Causes Of Postmenopausal Spotting
Other potential causes of postmenopausal bleeding include:
- Infection of the uterine lining, known as endometritis
- Injury to the vagina from the insertion of foreign objects or sexual trauma
- Some medications, such as tamoxifen for breast cancer or blood-thinning medications
- Sexually transmitted infections such as chlamydia, gonorrhea, and herpes can cause postmenopausal bleeding.
- Menopausal hormone replacement therapy
- In some cases, cancer of the cervix and vagina can also cause postmenopausal spotting.
Perimenopausal Bleeding Or Spotting
Perimenopause is the period that leads to menopause. Its usually characterized by menopausal symptoms and irregular periods. Perimenopause can last up to 10 years. During perimenopause, its normal to experience heavier periods or irregular spotting due to hormonal changes.
Talk to your doctor if your perimenopausal bleeding:
- lasts longer or is heavier than expected
- occurs more often than normal
- occurs after intercourse
There are many conditions that can cause bleeding after menopause. Here weve listed the most common causes of postmenopausal bleeding.
Bacterial Vaginosis : : Differentiating Between Periods Blood And Infection / Tear Bleeding
I was getting oral sex from my bf and he was also fingering me after I noticed my right Liberia minora lip was swollen. Do you know anything that could help the swollen go down?! I’m only 15 . It was my first time getting oral so I concluded that the swollen lip was bleeding but then after I showered I noticed it was coming from my vagina in the last two weeks I took Plan B three time and my dr stayed it might delay my period so, I’m currently not sure if have a tear in my vaginal walls bc he could have done it while fingering me or if I just got my period.
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Birth Control : : Bright Red Blood With Some Small And 10 Cent Piece Size Clots
I’m a 23 yo female. I have been skipping my periods on levlen ED for about 2 years. Have had breakthrough bleeding about i’d say 4 times, which definitely wasn’t like this one… i had a breakthrough bleed recently a week before i had tummy cramps & felt rather nauseous then got my period that lasted 10 days it stopped i had intercourse with my partner it came back lightly went away & once again with my partner afterwards there was bright red blood with some small & 10 cent piece size clots… i have always had the occasional bleed after intercourse but not like this.. i do have hpv & have a med- large lump inside i was told to leave it & it should go away.
Why Am I Experiencing Vaginal Bleeding After Menopause
Vaginal bleeding after menopause may be due to medications, hyperplasia of the uterus, or some types of uterine cancer. Certain medications containing estrogen or progesterone can cause either hyperplasia or an increase in the amount of tissue in the uterus, which may cause bleeding or an excess sloughing off of tissue both of which will be seen as vaginal bleeding.
Vaginal Or Endometrial Atrophy
As hormone levels decrease during menopause, the vaginal lining or the uterine cells may become thinner. This thinning is called vaginal atrophy or endometrial atrophy.
Vaginal atrophy often causes the vagina to become drier, less flexible, and more susceptible to inflammation or infection than before menopause. Vaginal atrophy may lead to:
- brown spotting
- bleeding after sex
The vagina may feel continuously uncomfortable, so a woman with these symptoms should speak to a doctor. A doctor may recommend hormone replacement therapy, as well as the use of water-soluble lubricants during sexual activity.
Postmenstrual Bleeding Treatment Options
Treatment options for postmenopausal bleeding will largely depend on whats causing your symptoms. Estrogen therapy can be used to treat conditions such as vaginal and endometrial atrophy. Progestin therapy, on the other hand, is used to treat endometrial hyperplasia.
Polyps can be removed during a hysteroscopy, or they might require surgery. Cancer and severe cases of endometrial hyperplasia can require a hysterectomy. If youre diagnosed with cancer, your doctor will discuss several options with you, including chemotherapy, radiotherapy, and hormonal treatments.
As with most other conditions, the most important step when it comes to postmenopausal bleeding is to get an early diagnosis. Once you know whats causing your symptoms, you and your doctor will be able to discuss treatment options and decide on the best course of action for your individual case.
Discovering that youre bleeding after menopause can be scary, but in most cases, the underlying condition can be treated with simple therapeutic options. Ensuring your wellbeing and overall health should always be your main concern.
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Can Vaginal Atrophy Get Worse
Be sure to address your symptoms quickly with your healthcare provider. The sooner you get treatment, the less likely it is that your vaginal atrophy will worsen. For example, the longer you go without estrogen, the dryer the vagina will become. Without treatment, yes, your vaginal atrophy may get worse. Occasionally, atrophy can become so severe that it can significantly narrow the vaginal opening. This may make it harder to treat the atrophy if treatment is initiated too late.
Is Postmenopausal Bleeding A Reason To Worry
Menopause is the phase of your life when youre over the age of 45 and havent had a period for a year. It can be a little scary if youve gotten used to not having your period and are unexpectedly bleeding after menopause. However, not all causes of postmenopausal bleeding are serious.
No matter what, make sure to talk to your doctor about your postmenopausal bleeding. Regardless of whats causing your symptoms, youll need to go in for a checkup to get a definitive diagnosis.
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Is It Normal To Bleed After Menopause We Asked A Gynaecologist
Professor Stergios Doumouchtsis, a consultant obstetrician and gynaecologist, explains everything women should know about post-menopausal bleeding
Bleeding after menopause can be confusing and worrying, which isnt helped by a lack of open discussion around the subject. This unnecessary taboo causes lots of women to turn to Google for information, advice and support which is why we went straight to an expert for the facts.
One of the most Googled questions is: Is it normal to bleed years after menopause? The answer is no. As Professor Stergios Doumouchtsis, a consultant obstetrician and gynaecologist , explains: The menopause is when menstrual periods stop. Women are considered post-menopausal when they have not had a period for one year. Any bleeding or spotting after this time is known as post-menopausal bleeding or PMB.
If you are suffering bleeding, spotting or brown discharge after menopause, it is important to contact your GP for a check-up.Although bleeding after menopause is nothing serious in many cases, it can sometimes be a sign of cancer, Professor Doumouchtsis explains. This means early detection and treatment will increase the likelihood of a full recovery.
Here, Professor Doumouchtsis talks Red through the common causes of bleeding after menopause, potential treatment for post-menopausal bleeding and the assessment you should expect in your GPs treatment room.
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What Percentage Of Postmenopausal Bleeding Is Cancer
Most cases of postmenopausal bleeding can be attributed to conditions that are not usually serious and can be treated easily.Bleeding, for instance, might be the result of polyps or genitourinary syndrome of menopause , both of which are non-cancerous.However, 10 per cent of postmenopausal bleeding cases may be symptomatic of endometrial or cervical cancer, so it is vitally important to get it checked by a doctor.5 Research suggests that around 90 per cent of women with endometrial cancer experience vaginal bleeding .By assessing bleeding, medical professionals have a greater window to catch cancer early, when it is most treatable.
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Womans Day: Bleeding After Menopause
As the Womans Day story details, transitioning out of menopause comes with uncomfortable yet common side effects like hot flashes, mood swings and weight gain. But, if your body is suddenly experiencing period-like bleeding after menopause, its time to call your doctors office and make an appointment.
Menopause is considered official when a women does not have a menstrual period for one year. Typically, women enter menopause around 51 years of age, but it can range from as young as 40 to 58 years old. And before menopause begins, most women experience changes in their menstrual cycle.
During this transitionary time, your bleeding pattern may start to change due to some wild fluctuations in your hormone levels, Chan told Womans Day. At first, you usually have a shortening of the cycle. Then you may have a change in bleeding pattern. It can be lighter. Then theres a lengthening of the cycle. You may skip some periods before you stop altogether.
But If bleeding occurs after menopause, doctors need to rule out other conditions. Post-menopausal bleeding can be a symptom of endometerial cancer also called uterine cancer. About 10% of postmenopausal bleeding experience is due to cancer, the Womans Day article states.
Read the complete story here.
Can Uterine Polyps Be Prevented
There is no way to prevent uterine polyps. It’s important to have regular gynecological checkups. Risk factors such as obesity, high blood pressure, or taking tamoxifen to treat breast cancer may increase the chance of developing polyps. Uterine polyps sometimes return after treatment, and additional treatment may be necessary.
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Why You Should See A Gynecologic Oncologist
When postmenopausal bleeding is diagnosed as endometrial cancer, most cases can be cured with a hysterectomy. However, because endometrial cancer can spread into the lymph nodes, many patients also should have a lymph node dissection at the time of hysterectomy. Gynecologic oncologists are specifically trained to perform this procedure when it is indicated.If only a hysterectomy is performed and it turns out the lymph nodes are at risk, were left with difficult decisions. Should the patient start radiation therapy, or should she go back into the operating room to perform the lymph node dissection? Seeing a gynecologic oncologist immediately after diagnosis can avoid these complications, simplifying care and improving the chance of survival.Its not always easy to travel to a gynecologic oncologists office. Dallas-Fort Worth residents are lucky in this respect, as there are a number of us in the area. I have patients who come from several hours away because were the closest available clinic. While making the trip to see a gynecologic oncologist may be inconvenient, its important for your care.
How Is Postmenopausal Bleeding Treated
Treatment for postmenopausal bleeding depends on its cause. Medication and surgery are the most common treatments.
- Antibiotics can treat most infections of the cervix or uterus.
- Estrogen may help bleeding due to vaginal dryness. You can apply estrogen directly to your vagina as a cream, ring or insertable tablet. Systemic estrogen therapy may come as a pill or patch. When estrogen therapy is systemic, it means the hormone travels throughout the body.
- Progestin is a synthetic form of the hormone progesterone. It can treat endometrial hyperplasia by triggering the uterus to shed its lining. You may receive progestin as a pill, shot, cream or intrauterine device .
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The Reassuring News On Postmenopausal Bleeding
The analysis found that most post-menopausal bleeding is caused by a noncancerous condition, such as vaginal atrophy, uterine fibroids, or polyps. That information doesnt really differ from what doctors have historically thought about the incidence of endometrial cancer and bleeding, says Dr. Berkowitz. But it does finally put solid data behind those figures, which was missing in the past, he says. The researchers who conducted this study were looking for clues about postmenopausal bleeding and how it relates to endometrial cancer.
Bleeding After Menopause And Hysterectomy
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Can Stress Cause Postmenopausal Bleeding
As we women age, our bodies go through some drastic and remarkable changes. After the childbearing years, the 40s and the 50s, the female body begins to change away from procreation as the production of reproductive hormones naturally begins to decline. This phase of a womans life is called menopause and is signaled by 12 continuous months since the last menstrual cycle.
The average age in the United States for women to start menopause is around 51 years of age. There are three phases of menopause that women typically go through and they are perimenopause , menopause, and then postmenopause .
Many questions surround this phase of female life, and for the purpose of this article, we are going to look at the postmenopause phase and a common question that arises often.