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Post Menopausal bleeding could be a warning sign

Post Menopausal bleeding could be a warning sign

POST-MENOPAUSAL BLEEDING

Menopause occurs in a woman when she stops having her periods for more than a year. The average age of menopause is 45-55 years in women. Menopause happens because of the natural decline in female hormone (estrogen and progesterone ) production from the Ovaries. Ideally, if a woman has undergone Menopause she should not be having any bleeding.

However, if bleeding does happen, either as spotting or heavy bleeding then it is a cause for concern and one must visit a Gynaecologist.

Post Menopausal Bleeding

Causes for Post Menopausal Bleeding

 

1- Endometrial Atrophy  When a woman’s estrogen production declines, it leads to thinning of the endometrium which sometimes leads to bleeding. This is also called as Senile Endometritis.

2- Polyps these are non-cancerous benign growths that can grow either in the uterine cavity or in the cervical canal. These can lead to unusual spotting or heavy bleeding and sometimes may cause bleeding after sex.

3- Endometrial Hyperplasia – in this condition, the lining of the uterus becomes thicker rather than thinning out. This happens because of excess Estrogen production without the hormone progesterone to offset it. Endometrial Hyperplasia can sometimes lead to Endometrial Cancer. Endometrial hyperplasia is more common in women who are Obese.

4- Endometrial Cancer  This is cancer of the Uterine Lining. About 10% of women with postmenopausal bleeding have Uterine Cancer. The incidence of Endometrial Cancer increases in women who are Obese, Diabetic or Hypertensive.

5- Hormone Replacement Therapy In the first 6 months of Hormone Replacement Therapy, women may experience breakthrough bleeding. Women on Tamoxifen may have post-menopausal bleeding.

 

Tests Done to Find the Cause of Post Menopausal Bleeding

Regardless of the cause, it is very important to visit your doctor to find out the cause of post-menopausal bleeding. The various tests done in this regard would be:

 

1- Transvaginal Ultrasound this is the first test to be done. In this, an Ultrasound is done by inserting a probe through the vagina to visualize the Uterus. It helps to measure the endometrial lining, and how thick or thin it is. Ideally, the endometrial lining in post-menopausal women should be less than 5 mm.

2- Endometrial Biopsy This can be done as an OPD procedure by inserting a small thin tube through the vagina into the uterus. Cells are taken from the lining of the Uterus and sent for biopsy to know whether they are normal or cancerous.

3- Dilatation and Curettage This procedure involves admission on a daycare basis and is done under anaesthesia. In this the cervix is dilated, so that a larger piece of endometrium can be taken for sampling.

4- Hysteroscopy This is a technique wherein a thin telescope which is attached to a camera is inserted inside the Uterine Cavity to visualize it for any polyps or growths inside the uterus. This procedure requires a daycare admission and is a safe, simple and minimally invasive procedure.

What are the treatment options?

Once the cause of bleeding has been diagnosed, treatment depends on the underlying cause. In most cases, it may not be necessary to remove the Uterus but regular monitoring may be needed.

 

1- Polyps Removal of polyps is needed and this can be done by Hysteroscopy. If the polyps are Non-cancerous on biopsy, then removal of polyps is the complete treatment.

2- Endometrial Hyperplasia – For this condition, if the biopsy report shows no evidence of pre-cancer, then medications like Progesterones can be given. However, it is important to have regular checkups to ensure that the lining of the Uterus is not growing. Sometimes, for Endometrial Hyperplasia, removal of the Uterus may be needed.

3- Endometrial Cancer Hysterectomy or removal of Uterus is the only option for Endometrial Cancer. Along with the uterus, the tubes and ovaries are also removed. Depending on the stage of the cancer, sometimes Chemotherapy or Radiotherapy may be needed.

4- Endometrial Atrophy In this condition, the doctor may prescribe estrogens for a short period. About 10% of women may have Postmenopausal bleeding and in most cases, it may be because of simple curable causes. But in a few cases, it may need urgent attention as the cause may be life-threatening, so it is advisable to get yourself checked by a Gynaecologist at the earliest.

Doctor Profile

Dr Amita Shah is a leading gynaecologist in Gurgaon with vast experience in treating all major and minor female problems. She is the founder of ‘Global Women Clinic’ in Palam Vihar, Gurgaon. For more information or an appointment with Dr Amita Shah please call 9773975611

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Ankush Gaur
Ankush Gaur
2024-01-08
Excellent
Geeta Upadhyay
Geeta Upadhyay
2024-01-04
I would highly recommend Dr Amita Shah to anyone in need of a gynaecologist. She is incredibly professional and always takes care of her patients. I have never had an issue with her and she has always been very responsive to my needs. I would definitely recommend her to anyone in need of a gynaecologist!
Sandeep Ranga
Sandeep Ranga
2024-01-04
I had been suffering from severe pain and heavy bleeding for so many years.My ultrasound showed a large cyst in the uterus .All doctors had advised open surgery but Dr Amita Shah advised Laparoscopic surgery.Surgery was very smooth,I had no pain and my recovery was very fast.I am very thankful to Dr Amita Shah.She is a very skilled surgeon and very polite and gentle with her patients.Highly recommended for Laparoscopic surgery.
Parul
Parul
2023-12-28
I have made all the pregnancy visits to Dr. Amita Shah, and my end-to-end experience with her has been wonderful. I was someone who was absolutely terrified of needles, but with Dr. Amita Shah's constant guidance and good consultation, I could overcome a lot of my stress and worries related to delivery as well as during the pregnancy phase. Both the doctor and her clinic staff are helpful and amiable. She was all ears when it came to even the tiniest of details and issues, listened calmly and resolved all my issues. She was also constantly available via phone and WhatsApp to clear any doubts that popped up in my head in addition to the in-clinic visits where she eased my mind and resolved plenty of my concerns. At the time of my delivery, she offered complete mental support and her presence itself offered calmness to me. I highly recommend Dr. Amita Shah for her professionalism, empathy and supportive attitude. By God's grace, we are blessed with a baby girl in December, and I have been on the path to a smooth and fast recovery since then.
monika agarwal
monika agarwal
2023-12-13
My end to end experience with Dr. Amita Shah has been very amazing. I found her trustworthy in the very first visit. The medications very limited and She handled the emergency of water break very diligently and ensured safe delivery of my baby. She is calm, positive and considerate and will make your pregnancy journey beautifuI with no stress. I highly recommend Dr Amita Shah.
M Grewal
M Grewal
2023-12-11
I have been visiting Dr Amita for 11 years now. She has helped deliver my kids and then for few other concerns. She is very kind, empathetic, and very gentle. She understands and a great listener. Trust her completely.
Zoya Khan
Zoya Khan
2023-12-10
I consulted Dr Amita for my Scar Endometriosis, she not only understood my problem but at the same time explained the entire ailment in detail. She assisted me at every step, her calm demeanour and patience made it very comfortable for me. The best part was she was so approachable although the process. I became a fan of her the way she did my dressings, removed my drain pipe with no pain extremely softly, she has magic in her hands .The best gynaecologist I have ever met. God Bless her always. Thank you so much.
Suchismita Adhikari
Suchismita Adhikari
2023-12-05
Our experience with Dr Amita mam and her clinical expertise has been fabulous. Her staff, Ms Komal and Ms. Ashu are very kind and cooperative. Dr. Amita operated on my mother with such finnese. Explained each and every step in detail. She is a very good gynaecologist. Happy we found her to treat my mom.