Treating Post Menopause Bleeding
If you have postmenopausal bleeding it is important to have it investigated.
You will most likely be referred to a gynaecologist who may:
- ask you questions about the history of your health
- examine you
- do a blood test
- look at the inside of your vagina and cervix using special tongs . At the same time, they may take a tiny sample of your cervix for testing .
The kind of treatment you have will depend on what is causing the bleeding.
- Atrophic vaginitis;and;thinning of the endometrium;are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft;flexible ring which is put inside your vagina and slowly releases the medication.
- Polyps;are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic.
- Thickening of the endometrium;is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.
Before treatment there are a number of tests and investigations your gynaecologist may recommend.
All treatments should be discussed with you so that you know why a particular treatment or test is being done over another.
What Is Cancer Of The Uterus
The uterus is part of a woman’s reproductive system. It is the hollow, pear-shaped organ in the pelvis. The wall of the uterus has two layers of tissue. The inner layer or lining is the endometrium, and the outer layer is muscle tissue called the myometrium. The most common type of cancer of the uterus begins in the lining . Although the exact cause is unknown, increased levels of estrogen appear to have a role. Estrogen helps stimulate the buildup of the epithelial lining of the uterus.
But Here Is Why You Really Need To See Your Doctor
Endometrial cancer, which affects 2% to 3% of American women, is the most common type of gynecological cancer. According to the American Cancer Society, it most often affects postmenopausal women 60 is the average age at diagnosis. There is currently no way to screen for endometrial cancer. Identifying it early has become a pressing issue, because the incidence of this cancer has risen gradually but steadily over the past 10 years, according to the National Cancer Institute.
Endometrial cancer is a fairly common disease, and its unfortunately becoming more common due to the growing rates of obesity, says Dr. Berkowitz. A womans risk of endometrial cancer can increase substantially if she is obese. Generally, risk rises among women who are 50 pounds or more above their ideal body weight, he says.
This is because of the role estrogen plays in endometrial cancer. The most common type of endometrial cancer, known as type 1 cancer, is fueled by estrogen. Estrogen is produced by body fat, so women with a larger amount of fatty tissue generally have higher levels of estrogen. They also typically have more free estrogen, an active form that produces stronger effects. This may lead to cancerous changes in the uterine lining.
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Is It Normal To Bleed After Intercourse
Vaginal bleeding after sex isnt uncommon. Up to 63% of postmenopausal women experience bleeding or spotting due to vaginal dryness, and up to 9% of menstruating women experience the same, though usually from issues with the cervix.
Occasional, light bleeding is rarely dangerous and probably doesnt need the attention of a doctor. However, if youre postmenopausal or experience the following symptoms, you should make an appointment right away:
- Vaginal itching or burning
- A burning feeling while urinating
- Painful intercourse
- Severe abdominal or lower back pain
- Nausea or vomiting
- Heavy bleeding
- Unusual vaginal discharge
At the OB/GYN office of Dr. Hany H. Ahmed in Houston, Texas, youll find compassionate and comprehensive womens care. If youre bothered by vaginal bleeding after intercourse, Dr. Ahmed can diagnose the underlying problem and find an effective treatment.;
Heres what you need to know:
Watch For Chain Reactions
If spotting is a chronic problem after working out, there may be more than fluctuating hormones causing bleeding after exercise. The American Council on Exercise notes that “over-training” sometimes leads to a chain reaction that starts with chronic fatigue, also referred to as “low energy availability.“
When that happens, your body is forced to rob itself of nutrients like fat, protein and carbohydrates. In addition, other nutritional deficiencies may develop from heavy workouts, causing problems such as iron deficiency anemia.
These deficiencies may lead to spotting after exercise, as well as other menstrual cycle anomalies. Your doctor may order blood tests to verify any deficiencies that may be linked to the spotting issue. If so, cutting back on workouts and taking supplements may be the answer.
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What Should I Bring To My First Meeting With A Gynecologic Oncologist
Like any doctor visit, its a good idea to come prepared. At Fox Chase, when you make an appointment, youll talk with a nurse navigator who will help make sure you have everything you need for your first appointment. Many times, this will include:
- Medical records, including pathology and radiology reports
- A CD-ROM of pictures from any imaging tests, if possible
- A current list of all medications and supplements you are taking
- Your past medical and surgical history, including gynecologic and obstetric history
- Your family medical history, including a list of family members whove had cancer
- A list of doctors youre currently seeing
- Questions to ask your gynecologic oncologist
When To Seek Medical Advice
Many of us avoid consulting medical professionals about menstrual or intermenstrual concerns. However, if youre experiencing stress or anxiety due to uncertainty its always worth talking to your healthcare provider.
If theres nothing to worry about, theyll be able to set your mind at ease. However, there are times when spotting or bleeding between periods could be a cause for concern. And if thats the case, the sooner you see a doctor, the better.
If spotting is accompanied by any of the following symptoms, it warrants getting some medical advice.
- Heavy periods with a lot of clotting
- Irregular periods
- Pain or a burning sensation when peeing
- Unusual vaginal discharge and/or redness and itchiness
Even if you dont have any of the above symptoms, dont ever ignore spotting, abnormal vaginal bleeding or abnormal uterine bleeding in the following situations:
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Is Light Spotting Normal After Menopause
You may be wondering if light spotting is normal after menopause. In short, the answer is noits not considered normal to experience spotting of any nature after menopause. While some causes may turn out to be harmless, some spotting or bleeding after menopause can be quite serious. It may feel instinctual to brush off occasional spotting, but dont ignore it, as it may be caused by something you would not want to ignore.
How Much Bleeding Is Normal After Menopause
You may think you have reached menopause if you have not had a period for a few months. However, it is still possible to have a period up to a year after your last one. After 12 months without a period, any bleeding at all is not normal.
Up to 1 in 10 women experience bleeding or spotting after their menopause. In most cases the bleeding is not serious and a cause may not be found. However, it needs to be checked because sometimes it can be a sign of cervical or uterine cancer, so it is always important to see a doctor if you notice any vaginal bleeding after menopause.
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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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Rheumatologist & researcher, University of Otago, Wellington
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Health Navigator is an excellent ‘go-to’ site for New Zealanders. The articles are well written and very clear to understand. They provide enough information to make an informed choice as to where to go next. An excellent resource.
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Whether You Call It Spotting Staining Or Metrorrhagia Light Bleeding Between Periods Or Instead Of Them Is Part Of Perimenopause
Most of the time, spotting is nothing to worry about, but thats not always the case
When bleeding occurs at some point other than during your period, its never normal, but its usually nothing serious. If the bleeding is accompanied by pain that lasts a number of days or started after you began a new sexual relationship, its a good idea to see your doctor to find out what the cause could be.
During;perimenopause, metrorrhagia can last a few days and may even replace a normal period or suddenly occur between periods. As spotting happens often in the months leading up to menopause, some women wouldnt dare go out without being prepared for every eventuality. And if your cycle becomes irregular, you can say good-bye to wearing whichever kind of undies you like: avoid G-strings until;menopause.
Postmenopausal Bleeding: An Overview
During perimenopause , your menstrual cycles and periods gradually come to an end. The average length of perimenopause is four years and, during that time, your period can become irregular and there can be irregular bleeding between periods.
Just as periods maybe started out irregularly when you went through the changes of puberty, so they become irregular as you go through the changes of perimenopause and menopause.
Because of this gradual change, many individuals are unsure when perimenopause ends and menopause begins. In medical terms, menopause is confirmed 12 months after your last period.;
Bleeding after this point is called post-menopausal bleeding and it is considered abnormal bleeding.
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Management Of Spotting Between Periods
You can prevent bleeding or spotting between menstrual periods by employing your doctor’s advice and following these practical steps.
First and foremost, if you are on birth control, take them as prescribed. Avoid skipping doses or taking them irregularly, as this can cause spotting between periods.
Ask your doctor if you can limit your intake of blood thinners like aspirin.
Get a pap smear annually to screen for cervical cancer. This is a highly treatable condition that can cause vaginal bleeding.
Avoid uterine cancer by maintaining the right body weight. Obesity increases your risk for uterine cancer, which is especially common after menopause.
Avoid using intrauterine devices, which can cause spotting.
Manage your emotional stress, as it can cause spotting between periods. Try different techniques like meditation and exercise.
Keep a diary to record your cycles and the details regarding your bleeding. This can assist you in describing your symptoms to your doctor.
Finally, get to know your cycles and body patterns to determine if spotting is unusual or not. Any remarkable changes may need to be reported to your physician.
Do I Need To Get Pap Smears If I Have Had A Hysterectomy
Pap smears may be discontinued after a total hysterectomy unless the surgery was performed for cervical pre-invasive or invasive cancer or other uterine cancers, or if you are considered to be at high risk for other reasons; for example, if you are HIV positive , or have a weakened immune system. In these situations, Pap smears should be continued as determined by your doctor. Women who have had a hysterectomy and no longer need Pap smears should continue to have routine pelvic exams performed by their doctor.
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Bleeding After Menopause Isnt Considered Normal
If you Google vaginal bleeding after menopause, the search results are likely to send you into a panic.
Please dont panic. There are many explanations for spotting after menopause. And despite what Dr. Google says, it does not automatically mean you have cancer.
According to this study published by JAMA Internal Medicine, postmenopausal bleeding occurs in approximately 90% of women with endometrial cancer; however, only 9% of women with postmenopausal bleeding were diagnosed with endometrial cancer.
So, why the urgency to see a doctor?;
Well, endometrial cancer cannot be screened for, which means it can go undetected if symptoms are ignored.;
So, even though postmenopausal bleeding can occur for a variety of reasons, understanding that it can allow for early detection of endometrial cancer means its always worth investigation.
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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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.
What Will The Spotting Be Like
Whenever you change your routine, especially if you are exercising more vigorously, and if you have changed your diet, there is a good chance that you will see some occasional spotting. If you are spotting after exercise, and you are between your menstrual cycles, take note the color and quantity of the blood. The spotting should be brownish, as opposed to bright red, and it should be in a relatively small amount, unlike a regular flow. However, if youre spotting frequently, and the bleeding is consistently light and brownish, you should consider lightening up a little. It is very likely the more vigorous exercising is over stressing your body.
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What Will The Doctor Do If I Tell Her I Have Post
Dr. Jessie: When you come in to the office for bleeding after menopause, your doctor will take a thorough history to get a better idea where the bleeding might be coming from. She will do a physical exam and inspect the vulva, vagina and cervix to look for a potential source of the bleeding. Shell also do a pelvic exam to see if the uterus feels enlarged or the ovaries feel abnormal.
Because PMB is a warning sign for pre-cancer or cancer of the lining of the uterus, even if she finds a likely cause during the exam, your doctor will do some sort of an evaluation of the lining of the uterus. This may be an ultrasound to determine the thickness of the lining or it may be a biopsy of the lining of the uterus.