Postmenopausal Bleeding

Overview

Menopause, in medical terms, is permanent stoppage of your period. Women is said to entered menopause if there is no bleeding for 12 months since last periods. Bleeding or spotting that occurs after this point is called postmenopausal bleeding (PMB). 

It can be a symptom of noncancerous growths (polyps), vaginal dryness, or other changes in your reproductive system. Bleeding after menopause can also signify uterine cancer in about 10% of women. 

Hence, postmenopausal bleeding should be checked out by a doctor. Early detection can help successfully treat conditions causing bleeding after menopause (including cancer).

Everything You Need to Know About Postmenopausal Bleeding

What Is It |  Causes | Symptoms | Diagnosis | Treatment | Conclusion

What is Post Menopausal Bleeding?

Postmenopausal bleeding is defined as bleeding after a woman has gone through menopause. Menopause is a phase in a woman’s life that begins around the age of 51, during which her reproductive hormones start to decline, and her women’s menstrual cycles cease. 

Women’s menstrual bleeding reappears over a year since their previous period is considered abnormal. Light bleeding or severe bleeding are also possible.

Causes of Post Menopausal bleeding

There are a variety of reasons why women have postmenopausal bleeding. However, some of the biggest prevalent reasons are, for example, the following:

• Polyps: Polyps are masses that may form on the womb wall, and they can be rather painful. Most of the time, they are noncancerous, although they might produce unusual or severe bleeding. Polyps can develop within the cervical canal. When this happens, a woman may suffer bleeding while having intercourse.
• Endometrial atrophy occurs when the hormone estrogen ceases being generated in a woman’s body due to menopause, causing her endometrial lining to become thinner. Because of this, it is possible that the covering of the endometrium will be more prone to bleeding.
• Endometrial carcinoma is a kind of cancer that affects the lining of the endometrium. Endometrial cancer is thought to cause uterine bleeding in 10 percent of postmenopausal women who suffer uterine bleeding.

• Endometrial hyperplasia is a disorder in which the uterine lining thickens rather than becomes thinner, resulting in excessive or irregular menstrual flow. Overproduction of estrogen without enough progesterone levels to counteract it is most usually responsible for this disease. Endometrial hyperplasia is a condition that may occasionally result in the formation of endometrial carcinoma.

Sub Treatments For Gynecology

Symptoms of Post Menopausal bleeding

Postmenopausal bleeding may strike a woman with or without any additional symptoms. However, there may be indications. When bleeding occurs, it is important to know the reason.

 As in the postmenopausal era, many menopause signs, such as hot flashes, frequently begin to diminish. Nevertheless, postmenopausal females may also suffer additional symptoms. 

Diagnosis of Post Menopausal bleeding

Here are some important tests to detect PMB:

• Endometrial biopsy: histological evaluation of the endometrium that helps assess for atrophy, endometrial cancer, hyperplasia, or other histological abnormalities that can cause PMB. 
• Transvaginal ultrasound: this imaging technique is used for those who have uterine pathology (eg, polyp, leiomyoma). 

• Cervical cytology is done to assess the possibility of cervical cancer.

Treatment

What’s causing the bleeding will have a bearing on this. Various treatment options are:

1. Treatment with estrogen 

In the treatment of vaginal and endometrial atrophy, estrogen therapy is employed.  This hormone can be taken orally in form of pills, or cream for the genital area.

To apply the cream to your skin, you’ll need an applicator, a ring that is worn around the vaginal canal – It may be placed in place by either you or your doctor. It delivers a consistent dosage of estrogen for around three months and a tablet for the vagina – You’ll use an applicator to put it in. You may have to do it many times a week, or even every day.

2. Treatment with progestin

 Endometrial hyperplasia is treated with this synthetic form of progesterone. In addition, your doctor may prescribe a tablet or injection, vaginal cream or an intrauterine device.

3. Dilation and Curettage

The surgeon opens your cervix during this procedure. Then, the curettage procedure will take place. When endometrial hyperplasia results in polyps or thicker portions of the uterine lining, a thin instrument is utilized to remove them.

4. Hysterectomy

Uterus is partially or completely removed using this procedure. It might even be necessary for those with pre-cancerous endometrial hyperplasia/endometrical cancer. In addition, your ovaries or surrounding lymph nodes may also have to be removed in this surgery.

Conclusion

Treatment for postmenopausal bleeding is nowadays common and highly effective. If cancer is the cause of your bleeding, your prognosis will be based on the kind of cancer and the detected stage. Make sure you discuss all treatments with your doctor to know why a particular treatment or test is being done over another.

Reach out to our experts to know more about post menopausal bleeding, its causes and treatment.

Our Expert Team