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What Causes Fluid In The Uterus After Menopause

Endometrial Hyperplasia Without Atypia

Endometrial Cavity Characteristics in Women with Post Menopausal Bleeding After Uterine Artery…

When there are no atypical cells present, the chance of endometrial hyperplasia eventually becoming endometrial cancer is very unlikely. The evidence suggests that only about 5% of women with endometrial hyperplasia without atypia will develop endometrial cancer. It is also likely that this type of endometrial hyperplasia will resolve on its own over time.

Target Risk Factors

The first line of treatment is to look for risk factors that are modifiable. For example, if you are significantly overweight or obese, losing weight will help decrease the excess estrogen produced by fat cells. This will allow the lining of your uterus to reset itself.

Similarly, if you are taking hormone replacement therapy your doctor may either need to adjust your dose or recommend that you discontinue using it.

Progesterone

Your doctor may recommend using progestin treatments to counteract the thickening effect of the excess estrogen on your endometrium. Reasons your doctor may suggest treating you with progesterone include:

  • Observation and lifestyle changes didnt work
  • You are having abnormal uterine bleeding
  • You want the fastest result

The two types of progesterone suggested for the treatment of endometrial hyperplasia without atypia are oral progesterone or a progesterone-containing IUD. The evidence favors using the levonorgestrel IUD .

Hysterectomy

What Is The Prognosis For Endometrial Cancer

As in all cancers, the stage of the disease is the most important factor in determining a person’s outlook . Generally, the lower the stage , the better the outlook. The pathologist’s findings also affect the prognosis. After a woman’s staging surgery, her doctor will discuss the specifics of the cancer with her. Fortunately, most women who have endometrial cancer are cured.

Possible Treatments For Bleeding In Menopause

Depending on the test results and other underlying causes in regards to this occurrence, the doctor will decide whats the best treatment for your particular case. In case the cause of your postmenopausal bleeding are polyps, the treatment will involve removing the polyps surgically. If it happens that you have endometrial cancer, the most common course of action is to completely remove the uterus and surrounding lymph nodes. Chemotherapy and radiation might be necessary as well, in case cancer has already spread in the body. Women suffering from endometrial hyperplasia should effectively deal with the condition by taking adequate medication for it, which will then prevent the thickening of the endometrial lining. However, its always recommended to do regular checkups for cancerous cells. In case the cause of bleeding is the tissue thinning, it would be necessary to take vaginal estrogen. Anywhere between four and eleven percent of ladies may experience bleeding after menopause. Even though irregular bleeding and spotting are somewhat normal just before hitting menopause, once a woman doesnt get her period for more than a year and then experience bleeding should be a reason for concern. The cause of the bleeding doesnt have to be anything too serious and theres no need to panic, but its still better to book an appointment with your doctor as soon as possible.

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How Can I Take Care Of Myself After Uterine Cancer Treatment

After you finish treatment, your care team will talk to you about your follow-up visits. Its important to go to these appointments. During a follow-up visit, your provider will do a pelvic exam. Theyll also ask you about any symptoms. The goal is to make sure cancer isnt coming back and that youre feeling OK after treatment.

You can also talk to your provider about ways to live a healthier life after cancer. Eating well, getting enough sleep and exercising can help you feel your best.

A note from Cleveland Clinic

Uterine cancer includes endometrial cancer and uterine sarcoma. The disease is the most common cancer affecting a womans reproductive system. It usually happens after menopause. But it can affect younger women, too. Uterine cancer symptoms include vaginal bleeding between periods or after menopause. If healthcare providers catch uterine cancer before it spreads, surgery can cure it. If you experience any signs of uterine cancer, contact your healthcare provider.

Last reviewed by a Cleveland Clinic medical professional on 01/20/2021.

References

Causes Of Postmenopausal Bleeding

Uterine Ablation (Endometrial Ablation)

A variety of conditions can cause postmenopausal bleeding, including hormone therapy, infection, or the use of medications such as blood thinners.Some of the most common causes of postmenopausal bleeding are:

  • Cancer: Postmenopausal bleeding is a common symptom of endometrial cancer, but it also can be caused by cervical and vulvar cancer.
  • Endometrial atrophy: The tissue that lines the uterus can become very thin after menopause. As the lining thins, bleeding may occur.
  • Endometrial hyperplasia: Sometimes the lining of the uterus becomes thick, usually because of too much estrogen and too little progesterone. This is considered a precursor to endometrial cancer.
  • Fibroids: These growths develop in the uterine muscle tissue.
  • Polyps: These usually noncancerous growths can develop in the lining of the uterus.
  • Endometrial biopsy: A thin tube is inserted into the uterus and a tiny sample of the lining is removed. The sample is sent to the lab for examination.
  • Transvaginal ultrasound: An imaging device is inserted into the vagina to examine the pelvic organs.
  • Hysteroscopy: An instrument with a light and camera at the end, called a hysteroscope, is inserted into the vagina and through the cervix to examine the uterus.
  • Dilation and curettage : After enlarging the cervix, tissue is scraped from the lining of the uterus to be examined in a lab.

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How Is Endometrial Cancer Diagnosed

If you develop symptoms that might be endometrial cancer, make an appointment with your primary care doctor or gynecologist. A gynecologist is a special type of doctor that focuses on the female reproductive system.

Your doctor will ask you about your symptoms and medical history. They will perform a pelvic exam to look and feel for abnormalities in your uterus and other reproductive organs. To check for tumors or other abnormalities, they may order a transvaginal ultrasound exam.

An ultrasound exam is a type of imaging test that uses sound waves to create pictures of the inside of your body. To perform a transvaginal ultrasound, your doctor or other healthcare professional will insert an ultrasound probe into your vagina. This probe will transmit images onto a monitor.

If your doctor detects abnormalities during the ultrasound exam, they may order one or more of the following tests to collect a sample of tissue for testing:

After collecting a sample of tissue from your endometrium, your doctor will send it to a laboratory for testing. A laboratory professional will examine the sample under a microscope to learn if it contains cancer cells.

If you have endometrial cancer, your doctor will likely order additional tests to learn if the cancer has spread. For example, they might order blood tests, x-ray tests, or other imaging tests.

What Happens After An Endometrial Ablation

The recovery process will vary, depending on what type of ablation you hadand the type of anesthesia used.

If you had spinal, epidural or general anesthesia, you will be taken to therecovery room. Once your blood pressure, pulse, and breathing are stableand you are alert, you will be taken to your hospital room or sent home. Ifyou had the procedure as an outpatient, plan to have someone else drive youhome.

If you did not get anesthesia, you will need to rest for about 2 hoursbefore going home.

You may want to wear a sanitary pad for bleeding. It is normal to havevaginal bleeding for a few days after the procedure. You may also have awatery-bloody discharge for several weeks.

You may have strong cramping, nausea, vomiting, or the need to urinateoften for the first few days after the procedure. Cramping may continue fora longer time.

Do not to douche, use tampons, or have sex for 2 to 3 days after anendometrial ablation, or as advised by your health care provider.

You may also have other limits on your activity. These may include nostrenuous activity or heavy lifting.

You may go back to your normal diet unless your healthcare provider tellsyou otherwise.

Take a pain reliever for cramping or soreness as recommended by yourhealthcare provider. Aspirin or certain other pain medicines may increasethe chance of bleeding and should not be taken. Be sure to take onlyrecommended medicines.

Your healthcare provider will tell you when to return for more treatment orcare.

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The Following Patients With Uterine Fibroids After Menopause Should Cause Oncological Alertness:

  • Women with increased ovarian size
  • Patients with uterine myoma in postmenopause who are at risk are subject to mandatory surgical treatment to prevent the development of cancer of the female genital area.
  • Women entering menopause:
    • with large sizes of myomatous nodes
    • with submucous localization of uterine fibroids
    • with recurrent and atypical endometrial hyperplasia
    • with a combination of uterine fibroids and adenomyosis
    • with the severe neuroendocrine syndrome
    • in the absence of regression of uterine fibroids after menopause against the background of age-related extinction of ovarian function.

    In addition, the likelihood of activation of fibroids with menopause is increased in those women whose family history has had cases of this pathology. This is important to consider when treating uterine fibroids.

    Biopsy Findings Of Tissue Insufficient For Diagnosis

    Symptoms, diagnosis and treatment of endometrial cancer

    Endometrial tissue sampling resulting in findings insufficient for diagnosis is common. In a study of 97 consecutive women with postmenopausal bleeding evaluated by transvaginal ultrasonography and endometrial biopsy, a pipelle biopsy was able to be performed in only 82% of the women with an endometrial thickness of less than 5 mm 16. Of these women, a sample adequate for diagnosis was obtained in only 27%. There was no correlation between sample adequacy and parity or cavity length. In a meta-analysis of studies on women with postmenopausal bleeding, the range of sampling failure with biopsy was 054% 17. The associated sample size-weighted failure rate specifically with pipelle biopsy was 10.4% 17.

    Transvaginal ultrasonography can be useful in the triage of women in whom office endometrial sampling was performed but tissue was insufficient for diagnosis 18. In one study, 29.8% of women evaluated for abnormal uterine bleeding had an insufficient endometrial sample . No further evaluation is necessary after an insufficient endometrial biopsy if subsequent transvaginal ultrasonography demonstrates a thin echo in a woman with postmenopausal bleeding in whom bleeding has ceased Table 1. Because rare cases of endometrial carcinoma can present with an endometrial thickness of less than 3 mm, persistent or recurrent uterine bleeding should prompt a histologic evaluation of the endometrium regardless of endometrial thickness 10.

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    Postmenopausal Bleeding: Causes And Treatments

    What Causes It? Polyps: , after menopause, Theyre usually not Vaginal atrophy : , the first investigation done is the ultrasound, if bleeding occurs, But usually if things are caught in time they can be taken care of, Atypical endometrial hyperplasia raises the risk of endometrial cancer and uterine cancer, Thickened uterine lining after menopause, But usually if things are caught in time they can be taken care of, If abnormal cell changes are present, thickening and thickening of the mucous tissue of the uterus body, Uterine fibroids grow after menopause, since she isnt menstruating. Endometrial cancer can cause the lining of the uterus to thicken, These tissue growths show up inside your uterus or cervical canal, we can determine the ET and uterine size etc, So mine was definately over grown, Simple is a thickened lining without cellular changes, with pain and bloating, I also did a uterine biopsy, in which a sample of your uterine lining is removed and examined under a microscope.

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    Why You Shouldnt Ignore Postmenopausal Bleeding

    A woman is considered to be in menopause after 12 consecutive months without a period. You may experience irregular bleeding leading up to menopause, a stage known as perimenopause. But once youre in menopause, all vaginal bleeding should stop.There are benign causes of postmenopausal bleeding. For 10 percent of women, however, the cause is endometrial cancer.Early diagnosis offers the best chance to beat endometrial cancer. I urge women to treat postmenopausal bleeding as cancer until proven to be something else. I dont say this to scare people, but a healthy amount of worry in this situation is warranted.

    Why Might I Need An Endometrial Ablation

    Uterine Ablation (Endometrial Ablation)

    You may decide to have endometrial ablation if you have heavy or longperiods. You may also have it for bleeding between periods . In some cases, the bleeding may be so heavy that itaffects your daily activities and causes a low blood count becauseof it.

    Heavy bleeding is described as bleeding that requires changing sanitarypads or tampons every hour. Long periods are described as lasting longerthan 7 days.

    Menstrual bleeding problems may be caused by hormone problems. This isespecially true for women nearing menopause or after menopause. Othercauses include abnormal tissues such as fibroids, polyps, or cancer of theendometrium or uterus.

    Endometrial ablation lessens menstrual bleeding or stops it completely. Youmay not be able to get pregnant after endometrial ablation. This is becausethe endometrial lining, where the egg implants after being fertilized, hasbeen removed. Pregnancies that occur after an endometrial ablation are notnormal, therefore it is important to use a reliable form of birth control.You will still have your reproductive organs.

    Your healthcare provider may have other reasons to suggest endometrialablation.

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    Make Your Health A Priority

    Women are known to focus on their families first and put their own health second. But you cant care for loved ones if youre not healthy yourself. Listen to your body. Alert your doctor to any changes or abnormal issues such as postmenopausal bleeding as soon as possible.Dont stop seeing your general gynecologist for an annual exam when you hit menopause. Just because your reproductive years have ended doesnt mean those body parts go away! Your cancer risk increases as you age, and your gynecologist can screen for the disease and help you manage any conditions caused by hormone changes.If youre experiencing postmenopausal bleeding or have any concerns about your gynecologic health, request an appointment online or by calling .

    Fluid In Uterus After Menopause

    Uterine fluid retention following menopause is often the first red flag symptom for endometrial cancer in subjects who have past the menopausal stage. However, said occurrence might still be considered a minor problem caused by the physical changes to the uterus and other reproductive system components that may occur during and after menopause.

    Regardless, the presence of uterine fluid should always be investigated further in non-ovulating women and especially in subjects who have completed the menopausal stage. Stricken individuals should receive a thorough medical evaluation and undergo assessments utilizing diagnostic tools like ultrasound and Magnetic Resonance Imaging scans to rule out cancer or any other serious reproductive system problems.

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    What Are Treatments For Endometrial Cancer

      The treatment of endometrial cancer varies depending on the stage of the cancer. Staging is based on the findings from the initial surgery, which involves the removal of the entire uterus and cervix , the fallopian tubes, and the ovaries. These organs are examined to determine the extent of the cancer . During this operation, cells are collected from the peritoneal cavity and tested for cancer. Usually, the lymph nodes in the pelvis and surrounding areas are removed and examined for cancer. Only then is a decision made about treatment.

      Seatmate What It Is Fluid In The Uterus In The Elderly

      Fluid in endometrial cavity

      Many older women are faced with the term seatmate. What is it? It is not a diagnosis, but rather a condition that is characterized by the accumulation of serous fluid in the uterus. It becomes a consequence of gynecological diseases or surgery. To accumulate fluid in the uterus may for a number of reasons, so cerasomma requires careful diagnosis. In each case, treatment is chosen individually.

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      Postmenopausal Women Without Bleeding

      The utility of transvaginal ultrasonography to exclude pathology in postmenopausal women with bleeding should not be extrapolated to asymptomatic postmenopausal women without bleeding. In 1,750 postmenopausal women without bleeding who were screened for a selective estrogen receptor modulator study, an endometrial thickness of 6 mm or less had a negative predictive value of 99.94% for excluding malignancy and a 99.77% negative predictive value for complex hyperplasia 19. Among 42 women with endometrial thickness of greater than 6 mm, there was one case of adenocarcinoma and no cases of hyperplasia . In another study, 82 asymptomatic postmenopausal women had an incidental ultrasonographic finding of a thick endometrial echo suspected to be a polyp 20. All women underwent operative hysteroscopy. Of these women, a benign polyp was found in 68, submucosal myoma in 7, atrophic endometrium in 6, and proliferative endometrium in 1. One polyp contained simple hyperplasia. There were no cases of endometrial carcinoma or complex hyperplasia. The total complication rate was 3.6% . An asymptomatic population of postmenopausal Danish women who were randomly selected from a civil registry revealed that 13% had a nonbleeding polyp detected by sonohysterography 21.

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