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Postmenopausal Bleeding – What It Means & When to Seek Help

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If your periods have been absent for a year and you suddenly experience spotting, is it normal? This condition is called bleeding after menopause or postmenopausal bleeding, and it is not normal. It is a matter of concern, and you should immediately consult the best gynaecologist in  Delhi, India..

Today, I will explain the causes of postmenopausal bleeding and its treatment options.

I am Dr. Amita Shah, Senior Consultant Gynecologist & Laparoscopic Surgeon from Gurgaon.

When you do not get your periods for one full year, it is called menopause. If you experience any bleeding after menopause, whether it is just a small spot, a pinkish discharge, or an actual flow, you should immediately consult the best gynaecologist in Delhi, India.

Key Takeaway:

  • Postmenopausal bleeding is not normal and should never be ignored. However, 90% of the time, it is caused by minor issues that can be treated if diagnosed on time. With early detection, 100% treatment is possible.

Why does postmenopausal bleeding occur?

In most cases, the causes are benign (non-serious) and not a major concern. However, it is seen that in near about 10% of cases, postmenopausal bleeding can be an early sign of an underlying cancer. Therefore, it is crucial to get it checked without delay.

Causes and Treatment of Postmenopausal Bleeding

Causes of Postmenopausal Bleeding

Causes:

Atrophic Endometritis / Atrophic Vaginitis – The inner lining of the uterus (endometrium) becomes thin and inflamed after menopause, leading to bleeding.

Endometrial or Cervical Polyps – These are localized growths in the uterus or cervix that may cause bleeding.

Endometrial Hyperplasia – This condition occurs when the inner lining of the uterus grows excessively, sometimes becoming precancerous or cancerous.

Uterine or Ovarian Cancer – In about 10% of cases, postmenopausal bleeding may indicate underlying cancer.

Diagnosis:

If you experience postmenopausal bleeding, consult your gynecologist immediately. The following tests are usually advised:

Ultrasound – This can be a transabdominal or transvaginal ultrasound to examine the uterus.

Pap Smear – A test taken from the cervix to detect abnormalities.

Endometrial Sampling (Pipelle Biopsy) – Cells from the uterine lining are collected to check for abnormalities.

Hysteroscopy – A small camera is inserted into the uterus to examine its lining. If thickening is observed, a biopsy is performed.

Treatment of Postmenopausal Bleeding:

The treatment of postmenopausal bleeding depends on the diagnosis:

Atrophic Endometritis/Vaginitis – Treated with antibiotics or estrogen/progesterone therapy.

Polyps – Removed using hysteroscopic polypectomy.

Endometrial Hyperplasia (Non-Cancerous) – Managed with Mirena IUD in some women.

Precancerous or Cancerous Lesions – May require hysterectomy (uterus removal surgery).

Advanced Cancer Cases – Referred to cancer specialists for further treatment.

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Postmenopausal Bleeding What it Means & When to Seek Help

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