Genitourinary Syndrome Of Menopause
After the menopause, oestrogen levels fluctuate in a downward trajectory decline, which can lead to changes in the vagina. The vaginal lining may become drier, thinner, more fragile, and less elastic, often resulting in genitourinary syndrome of menopause , or vaginal dryness . GSM is the most common cause of postmenopausal bleeding.GSM is exceptionally prevalent amongst postmenopausal women. In most cases, it can be effectively treated with lubricants and moisturisers.
Does It Matter How Far After Menopause You Are Say Six Months Post
Dr. Jessie: It doesnt. Post-menopausal bleeding can be an indicator for abnormal cells in the uterine lining at any point after menopause. While there are probably more benign conditions that can cause some vaginal bleeding the closer you are to menopause , if you have gone a full year without a period, you need to get in to see your doctor.
Bleeding After Menopause: Its Not Normal
Too often I see women with advanced endometrial cancer who tell me they experienced postmenopausal bleeding for years but didnt think anything of it. This shows we need to do a better job educating our patients about what to expect after menopause.
Women need to know postmenopausal bleeding is never normal, and it may be an early symptom of endometrial cancer. Any bleeding, even spotting, should trigger a visit to your doctor as soon as possible. Dont wait to make an appointment until after the holidays or even next week. Do it today.
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Generations Of Women Have Trusted Chapel Hill Obgyn
Often, several different diseases present similar symptoms. Thats why its so important to have a local gynecologist who understands your medical history and has been a partner in your care. Generations of women have entrusted their care to us for decades. If youre experiencing any bleeding after menopause, we encourage you to schedule an appointment with us today.
For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.
Harvard Medical School. Postmenopausal Bleeding: Dont Worry But Do Call Your Doctor. Online.
Mayo Clinic. Bleeding After Menopause: Is It Normal? Online.
Why Do I Start Bleeding 14 Days After My Period
If you are bleeding about 14 days after period ends, then its likely due to pregnancy or implantation. You are taking aspirin. This drug prevents clotting resulting in increased bleeding. Are you more than 40 years? Get an endometrial biopsy done to rule out any form of cancer These are some asked questions about bleeding after period?
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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.
Should You See A Doctor If Youre Bleeding After Menopause
Yes, if a woman has an episode of postmenopausal bleeding, she should see her doctor for an assessment. This includes a pelvic gynaecological examination, a vaginal ultrasound and a hysteroscopy if indicated. Even if there is only spotting or brown dischargeâ or she is not sure and is feeling otherwise well â a doctorâs review is needed.
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Is It Normal To Bleed 12 Months After Menopause
It is not normal to bleed or spot 12 months or more after your last period. Bleeding after menopause is usually a sign of a minor health problem but can sometimes be an early sign of more serious disease. When detected early, most conditions causing bleeding after menopause can be successfully treated.
Its also normal for the number of days a girl has her period to vary. Sometimes a girl may bleed for 2 days, sometimes it may last a week. Thats because the level of hormones the body makes can be different from one cycle to the next, and this affects the amount and length of bleeding.
Period Again After None For 2 Years
I am 50 years old. I have not had a period for two years, but today I started. Is this normal?
26 likes, 1070 replies
Edited 4 months ago
I did have this happen to me also – postmenopausal bleeding – only a bit earlier . I could not attribute it to any particular changes and was frightened. Saw my family doc asap. He ordered a transvaginal ultrasound and I think I also had a smear. All was normal. You certainly should report this to your doctor, though – standard orders for any such bleeding. Call today.
Edited 4 months ago
I am so glad to have found this forum. Suddenly had a period after a 13 month period. I was not surprised to see it as two weeks prior had some signs that I was ovulating. But on being advised by a friend to see a doctor I googled post menopausal bleeding and was scared to death with what I read about it possibly being signs of cancer. I didn’t sleep last night as a result and will certainly get it checked out by the Doctor but I feel loads better to read that it seems to happen to quite a lot of women. Fingers crossed that everything is normal. But thanks everyone for sharing.
Edited 4 months ago
Sorry – should clarify: it is important to report vaginal bleeding that occurs AFTER 12 months have passed without a period. You clearly fall within that guideline.
Edited 4 months ago
i had a clear smear test this year but after 2 years of nothing, am having a heavy period. do i need to see doc still? i cant bare the thought of being poked about again.
How Is Bleeding After Menopause Treated
The treatment will depend on the cause, below we explain what treatment each of these conditions receives. Read on and find out how bleeding after menopause is treated :
- In the case of polyps, the ideal treatment is their surgical removal .
- On the other hand, if it is related to endometrial atrophy and endometrial hyperplasia, it is medically treated with some drugs.
- Finally, endometrial cancer legally treated with surgery applying total hysterectomy.
Regardless of when the bleeding occurs after menopause, it is important to go to the gynecologist immediately in this way, innumerable serious complications for the health of women can be avoided.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
If you want to read more articles similar to Bleeding after menopause: Is it normal? All Causes , we recommend that you enter our category of Female reproductive system .
The Reason Why You Should Never Ignore Bleeding After Menopause
Bleeding after a year of no periods after menopause could simply be down to low oestrogen levels affecting the lining of the womb which may be thickening or thinning.
Or it could be due to abnormal but harmless tissue growths known as polyps.
Professor Doumouchtsis added: A thickened lining of the womb could be caused by hormone replacement therapy, high oestrogen levels or being overweight.
Dont just assume your bleeding is normal and harmless, Professor Doumouchtsis said your specialist will need to examine you in order to identify the cause of the problem.
The main reason for this is to ensure that there are no potential signs of cancer.
The Professor explained: Tests may include examination of the pelvis and vagina to visualise the vaginal walls and the cervix, an ultrasound scan of the womb and pelvis, or an hysteroscopy, whereby a telescope is passed into the womb through the cervix to check for abnormalities, and tissue samples are taken at the same time for examination.
What happens next is determined by the results of the inspection or surgery.
Professor Doumouchtsis said: Depending on the results of the investigation and the cause of bleeding, you may need surgery to remove polyps or suspicious cells or more extensive surgery in cases of cancer.
When there is atrophy only, the solution may just be a course of vaginal oestrogen tablets or cream.
Its vital, however, that you dont ignore the problem and make an appointment straight away.
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Current Testing Practices Supported
Although people tend to think of biopsies as invasive and frightening, an endometrial biopsy is a simple procedure similar to a Pap smear, Dr. Chu explained. Like a Pap smear, it can be done in the doctors office and doesnt require anesthesia.
In their study, the researchers ran simulations in which they estimated how many women with postmenopausal bleeding would need to undergo additional testing to detect one case of endometrial cancer, based on varied levels of risk and different testing strategies. Assuming a 10% risk of endometrial cancer and that women underwent subsequent testing with ultrasound, they estimated that 7 women would need to have a biopsy to find 1 cancer.
Before sending a woman for testing, doctors should ask themselves: If she has postmenopausal bleeding, how high is her risk of cancer?” explained Dr. Wentzensen. “Our estimate of 10% supports the current practice of further evaluating these women.”
The Significance Of Bleeding After Menopause
Bleeding after menopause or “postmenopausal bleeding” can be defined as the resumption of vaginal bleeding at least 6 months after a woman experiences her last menstrual period. This assumes of course that she is indeed menopausal ie. in her late 40’s, perhaps having hot flashes and night sweats, mood swings, insomnia, perhaps experiencing some vaginal dryness.
Bleeding after menopause or “postmenopausal bleeding” can be defined as the resumption of vaginal bleeding at least 6 months after a woman experiences her last menstrual period. This assumes of course that she is indeed menopausal ie. in her late 40’s, perhaps having hot flashes and night sweats, mood swings, insomnia, perhaps experiencing some vaginal dryness. The bleeding pattern most women experience as they approach menopause is one where the periods become lighter, shorter in duration, and the interval between periods changes so that the periods are either somewhat closer together or intervals greater than her customary 28 days. Cycles may be missed entirely for a couple of months.
Polyps and fibroids are common benign growths that develop in the uterine cavity. The former is most often associated with irregular light spotting, staining or actual light bleeding. The latter may also present this way, but in fact may be associated with much heavier bleeding.
Cancer obviously requires a much more aggressive surgery, namely hysterectomy.
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There Are Several Potential Causes But Some Are More Serious Than Others
In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy , vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancera malignancy of the uterine lining, but only in a small number of cases. A 2018 study by the National Cancer Institute found that only about 9 percent of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.
Still, we want the option to intervene early if it is cancer, since treating it sooner leads to better outcomes, Mantia-Smaldone said.
If endometrial cancer is found early, a woman has a 95 percent chance of surviving the cancer for at least 5 years.
Should You Be Worried About Postmenopausal Bleeding
You’ve endured the hot flushes and the mood swings. You’ve survived the heavy, irregular bleeding. Once you come out the other side, maybe the menopause isn’t so bad – after all, you don’t have to put up with periods every month. But then you start bleeding again, and you’re not sure if it’s normal.
Reviewed byDr Hayley Willacy
17-Apr-18·3 mins read
Sound familiar? If it does, you’re in good company. Bleeding after the menopause is remarkably common, and accounts for 1 in 20 of all referrals to gynaecologists.
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I Have Postmenopausal Bleeding Do I Need To See A Doctor
Yes, you should always visit your GP or make an appointment with a gynaecologist if you notice any postmenopausal bleeding, even if it has only happened on one occasion. This includes minor spotting or brown/pinkish discharge.
At London Womens Centre, we are specialists in womens health problems, including postmenopausal problems and abnormal bleeding. To discuss your symptoms in confidence, book a consultation with us today.
Can I Wait And See If It Happens Again Before Going To My Doc
Dr. Jessie: Please dont wait! It is very likely that your bleeding is nothing to worry about and just a nuisance, but occasionally it can be a sign of something more serious. It is always worth a check-up!
If youre experiencing post-menopausal bleeding, please follow Dr. Jessies advice and schedule an appointment right away. If you dont have an ob/gyn, you book a virtual appointment at Gennev Telehealth. If youve dealt with PMB, what caused it and how did you deal with it? Please share with the community: leave us a comment below, or talk to us on our or in Midlife & Menopause Solutions, our closed Facebook group.
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Examining Endometrial Cancer Worldwide
To get a comprehensive picture of the relationship between endometrial cancer and postmenopausal vaginal bleeding, researchers led by DCEGs Dr. Clarke and Nicolas Wentzensen, M.D., Ph.D., performed a meta-analysis of 129 studies, which included more than 40,000 women. Data for the studieswhich were conducted in Europe, North America, and Asiawere collected between 1977 and 2017.
The researchers estimated the overall prevalence of endometrial cancer among women with postmenopausal bleeding across all the studies combined and within different regions of the world. They also examined whether factors such as use of hormone replacement therapy affect the prevalence of endometrial cancer.
Overall, the analysis showed that, consistent with what had been seen in earlier studies, 90% of women diagnosed with endometrial cancer had experienced postmenopausal bleeding.
The number of women with postmenopausal bleeding who were diagnosed with endometrial cancer varied around the globe. While the rate was 9% overall, it ranged from 5% in North America to 13% in Western Europe.
Among the studies included in the analysis, the risk of endometrial cancer in women with postmenopausal bleeding was lower in studies that included women using hormone replacement therapy. This may be due, in part, to the fact that hormone replacement therapy itself can cause bleeding, especially during the first 6 months of use, explained Dr. Clarke.
What Is Vaginal Atrophy
After menopause, your body makes less estrogen. As a result, you may have vaginal atrophy, which is the thinning, drying and inflammation of the vaginal walls. It can cause problems with urination such as:
- Recurring urinary tract infections
In addition, vaginal atrophy can make sex painful. Treatments include topical estrogen, vaginal moisturizers and water-based lubricants to make intercourse more comfortable.
What are uterine fibroids?
These tumors, which are almost always benign, develop within the uterine muscle tissue and often dont cause any symptoms. They are very common, and between 20 and 80 percent will develop fibroids before the age of 50.
When fibroid tumors do cause symptoms, they include:
- Painful intercourse
- Longer periods
- Abdominal or lower back pain
Only 1 in 1,000 fibroids are cancerous. While there is no one definitive cause for fibroids, researchers believe they can be influenced by hormones or genetics. .
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What Is The Most Common Cause Of Postmenopausal Bleeding
According to an analysis published in JAMA Internal Medicine, abnormal vaginal bleeding after menopause is typically caused by a noncancerous condition. Some of the most common examples include vaginal atrophy , endometrial atrophy, uterine fibroids, and endometrial polyps.
- Vaginal and endometrial atrophy: As estrogen hormone levels decrease, the uterine lining and vaginal tissue typically become thinner. This is known as atrophy, and it can cause postmenopausal bleeding.
- Uterine polyps and fibroids: Polyps and fibroids are noncancerous growths that grow in the uterus. These similar but distinct growths can both cause abnormal bleeding after menopause.
While these conditions are all common causes of postmenopausal bleeding, they arenât the only ones.
How Is It Diagnosed
To find the cause of your bleeding, the doctor will do a physical exam and review your medical history. You may need one or more of the following tests:
Transvaginal ultrasound: This image helps your doctor check for growths and look at the thickness of your endometrium. Theyâll place a small probe into your vagina. It sends off sound waves to create a picture of the inside of your body.
Endometrial biopsy: The doctor uses a thin tube to take a small sample of the tissue that lines your uterus. Theyâll send it to a lab where scientists will look for anything unusual, like an infection or cancerous cells.
Sonohysterography: Your doctor may use this test to measure the size of a polyp. Theyâll put a saltwater solution inside your uterus to create a clearer ultrasound image.
Hysteroscopy: When the doctor needs to look inside your uterus, theyâll use a hysteroscope. This thin, lighted tube has a camera on one end.
D& C : During this procedure, the doctor opens your cervix. They use a thin tool to scrape or suck a sample of the uterus lining. They send this to a lab that will check for polyps, cancer, or a thickening of the uterine lining .
Ultrasound and biopsy are usually done in your doctorâs office. Hysteroscopy and D& C require anesthesia on one part of or your whole body. Youâll either go to a hospital or an outpatient surgical center.
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