IS IT OKAY TO EXPERIENCE POSTMENOPAUSAL BLEEDING?
Menopause is a natural occurrence that is experienced, especially by women within the age bracket of 40 to 55 years. Menopause comes into course when the hormones of a woman begin to decline, and she no longer sees her period for about a year.
Usually, there is not supposed to be any further bleeding after the stage of menopause. However, further bleeding from the vagina may occur in some cases. These kinds of cases are not supposed to be. Hence, it is medically advisable for a woman to visit her doctor when she experiences the case of abnormal bleeding after menopause.
In most cases, the vaginal bleeding has nothing to do with menstruation but rather as a result of some other issues that would need to be diagnosed. For instance, post-sexual bleeding or heavy bleeding that is more than "spotting" are bleeding symptoms that would require visitation to your physician.
What Are The Causes Of Postmenopausal Vaginal Bleeding?
There are several causes of postmenopausal vaginal bleeding, and it is quite abnormal to experience it. In most cases, it is commonly caused by the following conditions below:
- Endometrial hyperplasia: this condition is most often caused when there is insufficient hormone progesterone to offset the production of excess estrogen. It, therefore, causes the lining of the uterus to get thicker rather than being thinner, thereby causing heavy or abnormal bleeding. This condition can give rise to endometrial cancer in some cases.
- Endometrial cancer: the percentage of postmenopausal women who experience uterine bleeding has been estimated to 10%. This is caused by endometrial cancer, which is a cancer of the endometrial lining.
- Endometrial atrophy: a woman's endometrial lining may begin to get thinner when menopause puts a halt to the production of the hormone estrogen. Consequently, there is a tendency that the woman would experience bleeding in her endometrium lining.
- Polyps:These are growths that can cause abnormal or heavy bleeding, although they are mostly non-cancerous. They are growths that can grow on the uterus lining. Sometimes, they also grow inside the cervical canal, and this may cause bleeding during sex for the woman.
There are also some latent but rare causes of postmenopausal bleeding, which are:
- Disorders relating to the thyroid
- Pelvis trauma
- urinary tract bleeding
- Clotting issues
- Tamoxifen and other hormone medications have a side effect that causes postmenopausal bleeding. A lot of women will, as a result of hormone replacement therapy, experience breakthrough bleeding in the first six months.
It is however, still necessary and vital for a woman to visit her physician whenever she experiences vaginal bleeding, regardless of the latent underlying factors.
How To Diagnose Postmenopausal Bleeding
The first thing your doctor would do to diagnose your postmenopausal bleeding will be to ask you about the signs and symptoms you have been observing. The doctor may ask the following questions:
- When did you begin to observe your symptoms?
- How much do you bleed?
- Do you have any postmenopausal bleeding in your family's history?
One or more tests might be prescribed by your doctor based on the symptoms you are experiencing.
Methods Of Diagnosing Postmenopausal Bleeding
- Endometrial biopsy: this process involves taking a sample of the uterine lining tissue by inserting a small, thin tube into the vagina to reach the cervix. Abnormal cells, which could include cancerous cells, are then treated.
- Transvaginal ultrasound: in this process, a special ultrasound probe is inserted into the vagina to enable the doctor to have a better view of the uterus from the bottom of the uterus and not from below the abdomen.
- Dilation and curettage (D&C): in this process, a larger tissue is extracted by dilation and widening of the cervix. Also, this process diagnoses any latent growths by using a special tool called hysteroscope to view the inside of the uterus.
- Sonohysteroscopy: this process enables a doctor to know if the lining of the uterus is thicker or thinner than supposed. This procedure can also be called transabdominal ultrasound. In this process, the uterus is infected with fluid through the vagina. Then, the uterus is visualised through the use of an ultrasound machine which identifies differences in tissues by using sound waves.
- Hysteroscopy: this method helps the doctor to diagnose irregular growths or polyps. In this method, the doctor examines the inside of the uterus and the uterine lining by inserting a tool with a thin, lighted camera on the end of it.
In most cases, the majority of these test methods can be carried out by a doctor in his office. However, some such as D&C procedure are mostly carried out at a hospital or surgery room.
In postmenopausal bleeding, the treatment that a doctor may prescribe is largely based on the underlying cause of the bleeding.
After testing, a doctor can use the information gathered to arrange the most efficient treatment plan. Below are some treatment options for some specific underlying causes of postmenopausal bleeding:
- Endometrial hyperplasia: doctors may recommend routine testing for cancerous cells in the uterus, to prevent the development of endometrial cancer. However, medications called progestins can be recommended for women with endometrial hyperplasia. These medications would help to stop the endometrial lining from being too thick.
- Endometrial cancer: most times, the treatment for this condition is a procedure called hysterectomy. It involves the removal of the uterus alongside any close lymph nodes which cancer could have spread to. Furthermore, a woman may have to undergo chemotherapy and radiation treatments based on how much cancer has spread.
- Polyps: the treatment plan for polyps could entail the removal of the polyps through surgery so that they stop to bleed.
The effects of thinning tissues can be curbed through the prescription of vaginal estrogen medication. This would help to stop the thinning of endometrial tissues that cause vaginal bleeding in women.
Perimenopause is a period when women may experience some abnormal bleeding before the attainment of menopause. However, bleeding afterwards is abnormal.
It isnecessary for a woman to call her doctor if she does have postmenopausal bleeding, even though it is not often a cause to worry. This is necessary to prevent severe cases such as endometrial cancer.
According to a study, vaginal bleeding is experienced by an estimate of 4% to 11% of women after they have gone through the period of menopause.
Majority of postmenopausal bleeding diagnosis can be done at your doctor's office. They do not have to be invasive.
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