Discussing the uterus, it is the reproductive organ which causes period in women, once every month. An egg is released to the uterus every month, by the ovaries, wherein it awaits fertilization by the male sperm or else will be discarded from the uterus in the monthly period of the woman. This monthly period is the menstrual cycle.
What is menopause and peri-menopause ?
Menopause is when a woman does not get her monthly menstrual periods for a year. The usual age at which menopause happens is 51 years but it could vary from anything between 45 to 55 years. The years that lead up to menopause are called the perimenopause (“peri” meaning around). This phase could last for almost ten years.
What is post-menopausal bleeding ?
Post-menopausal bleeding is any bleeding that occurs from the genital tract in women after their menopause, arising after a year of having no period (amenorrhoea) in women of menopausal age. Post-menopausal women will have different causes for uterine bleeding as women of reproductive age, so they should seek prompt care from a doctor for immediate treatment.
What is the cause for post-menopausal bleeding ?
Post-menopausal bleeding can be caused by various factors. While the commonest cause for post-menopausal bleeding is atrophy (wasting away), it is seen even in cervical and endometrial cancers. Atrophy accounts for the majority of all causes of Post-Menopausal Bleeding, whilst endometrial hyperplasia and cancer can also be causative factors. The remaining causes are attributed to endometrial or cervical polyps, exogenous oestrogen, and factors like vaginal trauma, anticoagulant usage (escosprin) and bleeding from non-gynaecological sites.
What are the clinical features of post-menopausal bleeding ?
Symptoms of post-menopausal bleeding include spotting or frank bleeding. There may be associated symptoms like changes in bladder or bowel function, pain, weight loss, nausea, vomiting, lethargy or fatigue. If the Post Menopausal Bleeding is due to atrophy of the vulva, and the vagina, or the uro-genital tract, symptoms of atrophy characteristically consist of dryness of the vagina, burning and pruritis.
How is post-menopausal bleeding diagnosed ?
- A complete physical examination of the body is mandatory. Body mass index has to be assessed, as obesity is a known risk factor for the development of endometrial cancer. An abdominal examination should include palpation for masses. A systematic pelvic examination may yield the cause of the Post Menopausal Bleeding. Examination should include a detailed inspection of the cervix, vulva and vagina, especially looking for atrophy, suspicious lesions, trauma and a foreign body. A speculum examination and a pap smear should be done as well.
- A thorough menstrual history including the full details of the woman’s menopause, the onset, duration and amount of post-menopausal bleeding is vital in the diagnosis of Post-Menopausal Bleeding. History of any trauma or changes in bladder or bowel function and associated factors such as pain and weight loss are also important to establish. Relevant details also include use of hormone replacement therapy (HRT), the type of the HRT (that is either continuous or cyclical, oestrogen and progesterone or only oestrogen), duration of its use and if the patient has had a hysterectomy.
- An ultrasound and endoscopic examination may have to be done, for diagnosis of the cause of Post-Menopausal Bleeding and to check presence of underlying problems.
- Ultrasound of the Uterus : This will have to be undergone to study the uterus and its lining. The uterine check-up involves pelvic ultrasonography, trans-vaginal ultrasound (TVUS) and other imaging tests. Mostly, MRIs are more of use than CTs in imaging pelvic structures.
- Hysteroscopy : This is a way the doctors can scan and examine the uterus. The doctor with the help of a miniature telescope inserted through the cervix, can see the entire uterus.
- Dilatation And Curettage (D&C) : A Dilatation And Curettage or a D & C may have to be performed. The patient’s cervix is opened or dilated and a particular curettage instrument removes tissue from the uterus. This is done in the operating room, when patient is under general anaesthesia. It helps in assessing endometrial tissue.
How is post-menopausal bleeding treated ?
For women with either cervical or endometrial cancer, immediate and prompt referral to the gynaecological oncologist is essential for the definitive management. If the post-menopausal bleeding is due to other causes, a gynaecologist along with the patient’s general practitioner can manage the disease. Cervical or endometrial polyps will be managed and removed in the diagnostic work up itself of Post-Menopausal Bleeding. As long as the lesion is benign, no further investigations or treatments are necessary. In these situations, it is patient education that is paramount, as any further episodes of Post-Menopausal Bleeding will require re-evaluation.
How to find gynecologists for the treatment of post-menopausal bleeding ?
Now you can find gynecologists for the treatment of post-menopausal bleeding from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple gynecologists, get approximate cost for the treatment of post-menopausal bleeding from various hospitals, compare things and then choose a gynecologist for the treatment of post-menopausal bleeding.
Find and choose a gynecologist for the treatment of post-menopausal bleeding on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
