Postmenopausal bleeding
Postmenopausal bleeding refers to any vaginal bleeding that occurs after a woman has gone through menopause, which is defined as the absence of menstruation for 12 consecutive months.
Pathogenesis:
- Hormonal changes: The primary cause of postmenopausal bleeding is hormonal changes associated with the menopausal transition.
- Endometrial abnormalities: Postmenopausal bleeding can also be caused by various endometrial abnormalities. The most common cause is endometrial atrophy, where the endometrium becomes thin and fragile, making it more prone to bleeding.
- Other potential causes: include endometrial hyperplasia (overgrowth of the endometrium), endometrial polyps (abnormal growths in the uterine lining), and rarely, endometrial cancer.
It is essential for women experiencing postmenopausal bleeding to seek her Gynaecologist attention promptly. While many cases are caused by benign conditions, it is crucial to rule out more serious underlying causes, including endometrial cancer. Early detection and appropriate management significantly improve outcomes and overall health.
Clinical features:
- Vaginal bleeding: Postmenopausal bleeding is characterized by vaginal bleeding with absence of other menstrual symptoms that occurs after at least 12 consecutive months of no menstrual periods. The bleeding may be light or heavy, intermittent or continuous, and may last for a few days or longer.
- Diagnostic evaluation: Any postmenopausal bleeding requires a thorough evaluation by your Gynaecologist. The evaluation may include a detailed medical history, physical examination, pelvic ultrasound, and endometrial sampling (biopsy) to assess the health of the endometrium and rule out underlying pathology. Additional tests such as hysteroscopy or imaging studies may be recommended based on individual circumstances.
- Management: The management of postmenopausal bleeding depends on the underlying cause. Benign causes such as endometrial atrophy or polyps may require conservative management or minimally invasive procedures like Hysteroscopy for removal. If endometrial cancer is detected, treatment options will be tailored to the stage and extent of the cancer and may involve surgery, radiation therapy, and/or chemotherapy.