Management of bleeding after menopause
Menopause is the time after the last period. Because the final periods can be irregular, menopause is confirmed 12 months after the last period. Bleeding or spotting after this point is called postmenopausal bleeding.
It may not be normal to bleed or spot 12 months or more after the last period.
Postmenopausal bleeding needs to be checked out; mostly, the cause will be something simple and treatable but occasionally it may be a sign of more serious disease.
Causes of postmenopausal bleeding may include
- Thickening of the endometrium ( lining of the womb) known as endometrial hyperplasia which can be precancerous.
- Growths in the cervix or uterus (called polyps) which are usually not cancerous.
- Thinning and inflammation of the lining of the uterus or of the vagina.
- Women on systemic HRT may have bleeding due to an imbalance between the estrogen and progesterone components.
- Postmenopausal bleeding can also be due to cancer of the endometrium or of the cervix.
What happens next
Treatment of postmenopausal bleeding depends on the cause and Mr Alak Pal will discuss this further with you. Thickened endometrium should be investigated with an endometrial biopsy and endometrial polyps are removed by surgery using a hysteroscope. Atrophic vaginitis may be treated with vaginal estrogen and if appropriate, progesterone helps in the control of thickened lining.
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