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What Causes Blood In The Urine After Menopause

You Have A Kidney Stone

Bleeding After Menopause

Sometimes the calcium, uric acid, salt, and other minerals in your urine can form hard clumps and collect in your kidneys. Occasionally, these stones cause no symptoms at all. But other times they travel down the tubes connecting the kidneys to the bladder and get stuck there, causing the kidney to swell. Or they can travel down to the bladder where they remain until you pee them out, which can be painful, too.

Other kidney stone symptoms:

  • Sharp cramps in the back or sides that move downward toward your groin or pain that comes in waves. The pain can range from unbearable to tolerable.

  • An urgent and/or constant need to pee

  • A burning sensation when you urinate

  • Fever or chills: If you have a fever, blood in the urine, and pain thats so severe you cant get comfortable go to the ER.

Kidney stone tests and treatment: Imaging tests like an ultrasound or CT-scan can tell your provider how big the stone is and where its located, and that can determine treatment. You may be given the option to pass the stone on your own if its small enough and you can tolerate the pain, even if it takes a few weeks. Or your doctor may give you Flomax that relaxes the ureter so its easier for stones to pass through. If the stones are very big or blocking your kidneys, you may need surgery.

You Worked Out Way Too Hard

Although rare, really strenuous exercisethink marathonscan cause red-blood and muscle cells to break down and exit your body when you pee. Officially called rhabdomyolysis, it can also occur when your body temperature gets too high . This is more common among men than women, and it can be very serious if not treated.

Other symptoms: Muscle swelling, weakness, and tenderness decreased urination

Tests and treatment: If the blood doesnt clear up on its own within a day, or comes back even if you havent had an extra-hard session at the gym, call your provider. There may be some sort of underlying issue, like kidney disease.

How Is Postmenopausal Bleeding Treated

Treatment depends on the cause of the bleeding, on whether bleeding is heavy, and if additional symptoms are present. In some cases, bleeding may require no treatment. In other situations where cancer has been ruled out, treatment may include the following:

  • Estrogen creams: Your doctor may prescribe estrogen cream if your bleeding is due to thinning and atrophy of your vaginal tissues.
  • Polyp removal: Polyp removal is a surgical procedure.
  • Progestin: Progestin is a hormone replacement therapy. Your doctor may recommend it if your endometrial tissue is overgrown. Progestin can decrease the overgrowth of tissue and reduce bleeding.
  • Hysterectomy: Bleeding that cannot be treated in less invasive ways may require a hysterectomy. During a hysterectomy, your doctor will remove the patients uterus. The procedure may be done laparoscopically or through conventional abdominal surgery.

If bleeding is due to cancer, treatment will depend on the type of cancer and its stage. Common treatment for endometrial or cervical cancer includes surgery, chemotherapy, and radiation therapy.

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How Doctors Classify Blood In Urine

Physicians call blood in your urine hematuria. Gross hematuria is blood that shows up in the toilet or after you wipe. It doesnt take much, either. One milliliter of bloodabout a fifth of a teaspoonis enough to turn your pee red or pink. Either way, if you see something, even once, make an appointment.

Then theres microscopic hematuria, which is what it sounds likeblood thats only visible under a microscope. Anything over three or four red blood cells is considered abnormal. Just dont be fooled by the amount. Doctors take microscopic levels just as seriously as they do gross hematuria because both types can be early signs of bladder or kidney cancer, especially if you have the risk factors for either cancer: youre a smoker, past or present, youre over 51, and you are male.

In a study done on 2,000 patients with microscopic levels of blood, researchers from Columbia University found that 1.2% had bladder cancer. So no, not huge numbers of people, but wed consider them lucky: All were diagnosed when the cancer was in its earliest and most treatable stages. Moral? Always get any blood in your urine checked out.

You Have Benign Tumors


Non-cancerous tumors can form in the bladder and kidney and cause blood in the urine. Benign bladder tumors are rare. Theyre more likely to grow in the kidneys.

Other benign tumor symptoms: They rarely cause symptoms, but if they do, kidney tumors can cause pain in your lower back. Benign bladder tumors can sometimes mimic the symptoms of a UTI.

Tests and treatment for benign tumors: The only way to tell whether a tumor is malignant or benign is to do a biopsy. Then the treatment depends on you and your doctor.

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Is Painful Urination A Symptom

Painful urination during menopause can be a symptom of this stage, but it is not the same problem as a urinary tract infection. Painful urination can accompany the loss of bladder control and/or a feeling of constantly having to go without really having to. These problems can be explained by hormonal as well as physical changes in a womans body.

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.

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Menopause And Your Urinary Tract

It has been debated whether the changes in a woman’s urinary tract with age are due to menopause and the lack of estrogen, or instead related to the aging process alone. We do know, however, that the bladder is loaded with estrogen receptors, so the reduction of estrogen that happens in menopause probably doesn’t help.

With age, the bladder begins to lose both its volume and its elasticity, and it’s normal to have to go to the bathroom more frequently. As the bacteria concentration in your genital region increases your urethra may thin, allowing bacteria easier access to your bladder. For these reasons, urinary tract infections are more common as women age. This risk begins to increase within four or five years of your final menstrual period.

The bladder also begins to thin, leaving women more susceptible to incontinence, particularly if certain chronic illnesses or recurrent urinary tract infections are also present.

The pelvic muscles weaken as you age. You may find that exercise, coughing, laughing, lifting heavy objects, or performing any other movement that puts pressure on the bladder can cause small amounts of urine to leak. Lack of regular physical exercise may also contribute to this condition.

What Are The Symptoms Of Vaginal Atrophy

Menopause & You: Bleeding After Menopause

Symptoms of vaginal atrophy can include:

  • Dryness of the vagina.
  • Have you tried over-the-counter lubricants or moisturizers?
  • Have you noticed any discharge?
  • Have you been bleeding or spotting?
  • How long have you noticed these symptoms?

Experts have observed that vaginal atrophy may be underdiagnosed. Mention it to your healthcare provider if you think your symptoms may match vaginal atrophy.

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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-18ยท3 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.

Urologic Dysfunction After Menopause Diagnosis

The initial exams and tests for all urinary problems after menopause are essentially the same. The doctor first asks about symptoms, medical and surgical history, medications, and habits, such as smoking, drinking caffeine, and exercising.

Women also undergo a physical exam. Depending on symptoms, the physical exam can include a vaginal, pelvic, and rectal exam.

For all conditions, but particularly for urinary tract infection, women are asked to provide a urine sample. Most often, women are asked to provide a “clean catch” sample, which means collecting the urine midstream after cleansing the area around the urethra. The following aspects of the urine are examined:

  • Amount and appearance of the urine
  • Chemistry of the urine, called a urinalysis, including tests to determine whether blood is present in the urine
  • Microscopy of the urine to check for infection or abnormalities
  • Culture of the urine

Urinary tract infections

In most cases, a urinalysis provides the doctor with all the information needed to treat a urinary tract infection. In some cases, the urine is cultured to see what kind of bacteria is responsible for the infection. This information helps the doctor determine what type of antibiotic the infection will respond best to. If a more complicated infection is suspected, such as pyelonephritis or kidney failure, a woman may be asked to undergo blood tests. Severe urinary tract infections usually require intravenous antibiotics and possibly a hospital stay.

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    What Are Some Symptoms Of Uterine Cancer

    Uterine cancer usually occurs after menopause, typically between the ages of 60 and 70. It also may occur around the time that menopause begins. Abnormal vaginal bleeding is the most common symptom of uterine cancer. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Women should not assume that abnormal vaginal bleeding is part of menopause. A woman should see her doctor if she has any of the following symptoms:

    • unusual vaginal bleeding or discharge not related to menstruation, most commonly postmenopausal bleeding
    • thin white or clear vaginal discharge after menopause
    • extremely long, heavy or frequent episodes of vaginal bleeding after age 40
    • difficult or painful urination
    • pain during intercourse
    • pain in the pelvic area

    These symptoms can be caused by cancer or other less serious conditions. Most often they are not cancer, but only a doctor can tell for sure.

    When Blood In Your Urine Means Bladder Or Kidney Cancer

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    If doctors have ruled out the other reasons, theyll want to check for bladder or kidney cancer if you have the risk factors. Besides a history of smoking and age, they include:

    • Having a family history of bladder or kidney cancer

    • Youre male

    • Youre obese

    For bladder cancer, one of the main signs is painless blood you can see. In a study of nearly 1,200 people with gross hematuria, urologists at Weill Cornell Medical College in New York City found that 31% of them had bladder cancer. But that number more than doubled for those current or former smokers who were older than 65. Sounds scary, right? But one thing thats good to know is that the majority of bladder cancer patients are diagnosed before the tumors have spread too far into the bladder.

    The early stages of kidney cancer usually dont produce symptoms, but larger tumors will cause blood in the urine.

    Other symptoms of cancer: Very rarely, bladder cancer symptoms mimic a UTIburning and a frequent need to go. People with kidney cancer might have a pain on one side of their lower back, weight loss, fatigue, anemia, and a fever.

    Even if you do have cancer, remember this statistic: If the tumor is just confined to the inner lining of the bladder or inside the kidney, your five-year-survival rate is over 90%: Specifically? Its 93% for kidney cancer and 95% for bladder cancer.

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    Reframing Your Physical Symptoms

    Even with the possible solutions mentioned above, the changes in your reproductive and urinary organs at menopause can be irritating. Sometimes, rather than a physical solution to these challenges, a psychological “fix” might be the answer. When we can’t change a situation in life, sometimes we can still change our emotional response to the situation. This is where reframing can be helpful.

    Cognitive reframing is a tool in which a situation does not change, but your reaction to the situation or your perspective on the situation does change. With menopausal symptoms, this may include looking not at the negatives of your situation, but the positives instead. Instead of focusing on your vaginal dryness and how it affects your sex life, perhaps focus on how you are free to have sex whenever you wish without the thought of birth control. If the cost of vaginal lubricants disturbs you, consider how much money you are saving on pads and tampons. There is also a freedom that comes with no longer needing to make sure you have these menstrual products on hand.

    Reframing is not always easy to do, and sometimes you may need to “fake it until you make it.” Yet there are often a number of hidden silver linings in nearly any situation.

    Trying to create a sense of gratitude can also be helpful. Many people have found that keeping a gratitude journal is a good way to shift their frame of mind from the negative to the positive. Try to think of three positives in your life each and every day.

    What Causes Hematuria

    • Exposure to chemicals in the workplace
    • Treatment with radiation for pelvic cancer

    “In many cases, kidney cancer and bladder cancer do not cause physical symptoms, so the tumor may continue to grow without a person being aware of it,” says Michael J. Kennelly, MD, Professor in the Department of Surgery, Division of Urology at the Carolinas Medical Center – Charlotte in North Carolina. “By the time the tumor does cause symptoms, it may not be curable. That’s why it is so important to seek medical attention if you see blood in your urine. It could be a warning sign for a potentially life-threatening illness. Fortunately, the majority of the time, blood in the urine is not a sign of a serious illness.”

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    When To See A Doctor

    You should see a doctor anytime you see blood clots in urine because it may be a sign of a disease or condition that needs immediate treatment. The presence of other symptoms like severe flank or back pain, fever, and other unusual changes must prompt you to seek emergency consultation because you may have a severe urinary tract infection or stone that can affect your genital health. Bloody urine with loss of appetite and unexplained weight loss may be associated with cancer in the urinary tract and needs serious treatment.

    Most Common Causes Behind Blood In The Urine

    What is the Cause for Blood in Urine –

    Some of the most common causes of the presence of blood in the urine are:

    Urinary tract infections : A UTI occurs when bacteria enters the body by way of the urethra and grows in the urinary bladder. Apart from blood in urine, the other symptoms of a urinary tract infection are a constant urge to pass urine, urine with a very strong smell, and burning and pain while urinating.

    Pyelonephritis : Kidney infection occurs when bacteria travels to the kidneys from the lower urinary tract or gets into the kidneys from the blood. Symptoms and signs of pyelonephritis are usually similar to a UTI, though they may also cause flank pain and fever.

    A kidney or bladder stone: If your urine is concentrated, then the minerals present in it may form crystals in the bladder or kidneys. Gradually, these crystals may form tiny, hard stones. They are usually painless unless they get passed or result in a blockage, when they may cause very severe pain along with both microscopic and macroscopic bleeding. They may lead to the occurrence of blood clots in urine.

    Urinary tract and kidney infections, as well as bladder stones, are among the most common causes of blood in the urine.

    Kidney disease: Blood in the urine may also occur due to an inflammatory kidney disease called glomerulonephritis. Vasculitis , and immune system problems after strep or viral infections for instance, IgA nephropathy that affects the glomeruli may trigger glomerulonephritis.

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    Symptoms Of Postmenopausal Bleeding

    Many women who experience postmenopausal bleeding may not have other symptoms. But symptoms may be present. This can depend on the cause of bleeding.

    Many symptoms that occur during menopause, like hot flashes, often begin to decrease during the postmenopausal time period. There are, however, other symptoms that postmenopausal women may experience.

    Symptoms postmenopausal women may experience include:

    • vaginal dryness

    A doctor may conduct a physical exam and a medical history analysis. They may also conduct a Pap smear as part of a pelvic exam. This can screen for cervical cancer.

    Doctors may use other procedures to view the inside of the vagina and the uterus.

    Treatment For Blood Clots In Urine

    If you see a change in the color of your urine and you are thinking if it may be blood, you must initially consider what the possible causes are, which may include presence of your menstrual period or current drug intake. You may want to observe if the blood in urine persists after a few times you have urinated or after a day. Observe for other symptoms like pain, fever, or changes in urine character. It may help to rest, in the case of bleeding after strenuous exercise, and increase fluid intake, in mild cases of urinary tract infections. Over-the-counter pain relievers can also help relieve mild pain and fever.

    In the presence of other symptoms, do not attempt to take home remedies on your own. It is advisable to get proper medical advice.

    Medical Treatment

    Most cases of gross hematuria will need proper diagnosis and treatment:

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