Bleeding After Menopause Could Be a Problem. Here's What The Expert Says

Oct 18, 2022, 13:56 IST

Menopause

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The menopause is said to be a condition that happens in women older than 45; who have not had a period for more than a year. Any vaginal bleeding after a year of total cessation needs medical treatment.

It can be difficult to determine the source of the bleeding. It may originate from the rear passage or the anus. Occasionally, blood may be spotted after urinating if a urinary infection is present. While cleaning with a tissue, one may see a tiny stain. Regardless of the circumstance, it is essential to undertake a complete evaluation. A visit to the gynaecologist is essential, even if it has only occurred once and if it consists of spotting or a pinkish or brownish discharge.

"In some cases postmenopausal bleeding can be a sign of cancer in the reproductive system, which includes the ovaries, womb or uterus, cervix or the neck of the womb, and vagina," says Dr. Aruna Muralidhar MD, MRCOG, FRCOG (UK), Senior Obstetrician and Gynecologist, Fortis Hospital, Richmond Road, Bangalore who advises to be watchful of the warning signs.


Menopause
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The Expert Shares Some Of The Reasons For Bleeding
· The causes of postmenopausal bleeding are many. The most common causes are inflammation or thinning of the vaginal or the womb lining due to the low estrogen levels resulting from menopause.

· Polyps or benign outgrowths from the cervix or the uterine lining can cause this kind of bleeding. Polyps are generally not cancerous.

· Sometimes, local infection may cause excessive vaginal discharge which may be blood-tinged.Thickened womb lining can also cause bleeding. The thickening can be a result of high levels of estrogen either because of external hormone replacement or excess production within the body which happens in overweight women.

· Less commonly, bleeding can be due to cancer arising from the ovaries, womb, cervix, vagina or vulva.


Menopause
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What One Must Do
A visit to the gynaecologist can put your worries to rest most of the time. Usually the doctor enquires about the onset and duration of the bleeding, the amount and the nature and associated symptoms such as pain in the lower tummy, abnormal discharge, urine and bowel problems as well as the use of any hormone replacement or blood thinners etc. History of any medical problems, surgeries and allergies are also important to ascertain. It is important to inform the gynaecologist of any family history of cancers.

“I find examination a vital part of the consultation. A thorough examination will give us valuable clues to the origin of bleeding. An internal pelvic examination will often reveal the probable cause. However, often we request an ultrasound scan to evaluate the ovaries and the womb lining,” says Dr Aruna, who feels an ultrasound scan finding helps the doctor to plan further investigations and treatment. “For example, if the womb lining is thickened, we may have to do a biopsy of the womb lining through a simple procedure. The pathologist who studies the biopsy sample will be able to give us a definitive diagnosis after which we can plan treatment. In rare situations, the biopsy may reveal womb cancer which would then require complete removal of the womb, the tubes on both sides and the ovaries,” she adds.

If the biopsy merely reveals endometrial hyperplasia or uterine thickening without any indication of malignancy, it is not a case of concerns, assures the expert. In conclusion, menopausal bleeding must be addressed, and it would be good to consult a gynaecologist with experience treating such disorders.

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