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Post Menopausal Bleeding

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What is Post-Menopausal Bleeding, its treatment, and what is its Cost?

Post-Menopausal Bleeding is when you have not had your period for one year. And any bleeding that happens after that is called postmenopausal bleeding.

Most women who experience bleeding after menopause are understandably concerned.

The question is: what it could be having?

Postmenopausal bleeding can range from light spotting that is pinkish-gray, brown, or bright red, all the way to a heavy flow, like a regular period. Most of the time, there is no pain with the bleeding.

POST-MENOPAUSAL-BLEEDING-Dimple-Dosh-Goregaon-WestNo matter your exact symptoms, you’ll want to get in touch with your gynecologist right away if this happens to you. Chances are, there’s no reason for panic. But only through careful evaluation; we can be sure of what we’re dealing with.

 

Causes of Postmenopausal Bleeding

  1. Uterine polyps: Polyps are benign non cancerous growths in your uterus or cervix.  These polyps can cause bleeding or spotting after menopause.  Some of these polyps are seen directly by your gynaecologist on routine examination while the inner or uterine polyps can be detected by ultrasound.
  2. Thickened endometrium or inner lining of the uterus becomes thick. After menopause, the endometrial thickness should be less than 5mm. If this lining becomes thick; it can lead to  postmenopausal bleeding.
  3. One reason for postmenopausal bleeding could be that the skin a mucosa of your vagina and vulva has become thinner due to menopause and hormonal changes. If you experience the bleeding after sex, it may be from friction against this thinner, more sensitive skin. But you must contact your gynaecologist for the same.
  4. If you are taking any pills like hormonal pills; blood thinners; psychiatric medicines or breast cancer medicines etc.
  5. Cancer of the body of the uterus or cervix  is the most serious cause of bleeding after menopause.

What to do if Bleeding Happens after Menopause

Act now not Later

Visit your gynecologist as early as possible.

Important points your gynecologist will note down are:

  1. Since how long is the bleeding happening
  2. How much bleeding is there? Is it spotting or frank bleeding
  3. Are pain and/or foul smelling vaginal discharge also present
  4. Are you taking any pills?
  5. Are there any associated medical conditions like diabetes, hypertension or any other diseases

This will be followed by your pelvic exam; here your gynecologist  will look at your vagina, cervix and will feel the size of the uterus.

First investigation will be the ultrasound.

Pelvic ultrasound will reveal thickness of the endometrium or inner lining of your and also detect the presence of any fibroid or polyp.

Treatment of Postmenopausal Bleeding

Hysteroscopy with dilatation and curettage:

Hysteroscopy is an outpatient procedure where your gynecologist will insert a tiny, slender telescope through the vagina;  cervix and into the uterus. Initial examination of the inside of the uterine cavity will reveal presence of any abnormal mass or tissue which can be removed at the same time with hysteroscopic guidance. And this will be followed by D and C. All the material will be sent for histopathological examination.

Here it goes without saying that hysteroscopy is a far superior method of detecting any abnormalities in the uterus as we can directly see the inside with a magnified view.

Even if it isn’t cancer, you may need follow-up ultrasounds to keep an eye on things as advised by your gynecologist.  If you find the bleeding or follow-up tests to be very bothersome, and other treatments haven’t worked, talk with your gynecologist. In some cases, you could consider a hysterectomy to remove your uterus. You and your gynecologist can discuss what might be right for you.

If spotting or bleeding is happening due to vaginal thinning; your gynecologist will prescribe estrogen cream.

Hormonal pills will be prescribed by your gynecologist if biopsy of inner uterine lining is showing hyperplasia or thickening. 

In case of detection of malignant cells; your gynecologist will refer you to the gynec onco surgeon. Dr Dimple Doshi has the wide experience of dealing with ladies problems with an expertise of hysteroscopy and hysteroscopic procedures like polyp removal. Postmenopausal bleeding should never be ignored or taken lightly.

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