Bleeding or spotting after menopause are common reasons why patients visit a gynecologist. Postmenopausal bleeding or spotting is abnormal and is usually caused by minor changes in the genital tract. However, in some women - especially those at risk - postmenopausal bleeding may even indicate cancer.

Postmenopausal bleedingis a medical emergency. Normal menopause, i.e. the last menstruation in a woman's life, occurs around the age of 50. If there is no more bleeding for 12 months after the end of the menstrual period, it means that the woman has entered the postmenopausal period. Bleeding and spotting that occurs one year after your last period are abnormal.

Postmenopausal bleeding - causes

  • hormone replacement therapy - its use increases the probability of bleeding five times
  • ovarian cysts - apart from bleeding, there may be pain in the lower abdomen (possibly in the area of ​​the sacrum), nausea and vomiting
  • uterine fibroids - in this case, bleeding may be accompanied by sharp pains
  • uterine polyps: cervical and endometrial - most polyps do not cause any discomfort. It is only when they grow large that there is spotting and bleeding
  • vaginal atrophy - after the menopause, as a result of the decreasing level of estrogen, the thickness of the vaginal epithelium may decrease. There is then a feeling of dryness in the vagina, burning, itching of the intimate parts, and even bleeding

Any vaginal bleeding that occurs one year after the last menstruation requires consultation with a gynecologist. Even if it was short-lived, it was not very abundant and never came back.

  • atrophic changes of the endometrium (endometrium) - after the menopause, due to the decrease in estrogen levels, the endometrium becomes very thin and the vessels under it become very fragile. These may start to burst, causing bleeding or spotting
  • prolapse of the vagina and / or uterus - this causes damage to the uterus and vagina, which may result in bleeding
  • cancer of the vagina, cervix or endometrium. For endometrial cancerpainless bleeding occurs early in the development of the disease. It is worth knowing that obese women suffering from hypertension and diabetes are more likely to suffer from it. However, in the case of cervical cancer, bleeding is sometimes the only symptom of cancer. Vaginal cancer, on the other hand, is a very rare cancer and can manifest itself with vaginal bleeding or blood loss
  • blood diseases, incl. hemorrhagic diathesis, e.g. hemophilia or von Willebrand disease
  • use of certain medications, e.g. anticoagulants

Sometimes vaginal bleeding can be confused with urethral bleeding (which indicates urinary tract diseases) or rectal bleeding (which may be caused by haemorrhoids, such as hemorrhoids, polyps, and tumors).

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Postmenopausal bleeding - diagnosis

In the event of postmenopausal bleeding or spotting, please see a gynecologist who should perform the following tests:

You should visit the gynecologist while the bleeding is taking place, and not wait for it to subside. Then it is easier for the doctor to determine the cause of the bleeding.

  • cervical colonoscopy
  • transvaginal ultrasound
  • pelvic magnetic resonance imaging (performed if changes are detected in the ultrasound)
  • hysteroscopy - a test to assess the condition of the inner walls of the uterus
  • biopsy of the uterine mucosa (endometrium)
  • histopathological examination of the collected fragments of the uterine mucosa

Postmenopausal bleeding - treatment

Treatment of postmenopausal bleeding depends on the cause of its occurrence. For example, in atrophic vaginitis, hormone replacement therapy is used to replace the estrogen deficiency.

Moisturizers and lubricants are good for small vaginal atrophy.

If the cause of postmenopausal bleeding is uterine fibroids, painkillers or anti-inflammatory drugs are used, and in justified cases - hormonal drugs. They can also be removed operationally.

Category:

Female diseases