Postmenopausal Bleeding

Menopause is diagnosed if a woman has not  had a period in at least one year. Postmenopausal bleeding is not usually serious, but can be a sign of cancer. Cancer is easier to treat if it’s found early.

Any bleeding from the vagina after menopause should be checked by a Gynaecologist. One should seek urgent advice even if

• it has happened only once
• there is only a small amount of blood, spotting, or pink or brown discharge
• she does not have any other symptoms or
• she is not sure if it’s blood

The tests which a woman may need to undergo to find out the cause of abnormal vaginal bleeding are: General and local examination, Pap  smear of cervix, Colposcopy, Hysteroscopy, D&C (dilation and curettage)  and  Ultrasound scan

The most common causes of postmenopausal bleeding are:

• Atrophic vaginitis or endometrial atrophy
• Cervical or uterine fibroids or  polyps
• Endometrial hyperplasia
• Women on hormone replacement therapy
• Cancer

Treatment depends on what is causing the bleeding.

• Cervical polyps need to be removed.
• Endometrial atrophy case may be offered oestrogen cream or tablets.
• In cases of endometrial hyperplasia, depending on the type of hyperplasia, one may need hormone medicine (tablets or an intrauterine system) or a total hysterectomy(surgery to remove uterus, cervix and ovaries.
• Bleeding that cannot be treated in less invasive ways may require a hysterectomy. The procedure may be done laparoscopically or through conventional abdominal surgery.
• In cases of cancer the treatment depends upon the site and stage of cancer and may be surgery or radiotherapy or chemotherapy or a combination of any of these.

Prevention

Most important is that every women should visit a gynecologist for regular screenings. Although it may not be possible to prevent abnormal vaginal bleeding, regular check up by a gynaecologist can help detect any conditions early  including cancer which may decrease a woman’s morbidity and mortality to a large extent. To prevent abnormal postmenopausal bleeding, the best strategy is to reduce the risk factors that could cause it. Maintaining  a healthy lifestyle, a healthy weight, following a healthy diet and exercising regularly can prevent a variety of complications and conditions throughout the entire body.