After 15 Months of No Periods I Thought I Was in Menopause but Then I Got My Period Again.
Postmenopausal Bleeding
Postmenopausal bleeding is vaginal bleeding that occurs a year or more than later your last menstrual period. Information technology can be a symptom of vaginal dryness, polyps (noncancerous growths) or other changes in your reproductive system. In well-nigh x% of women, haemorrhage after menopause is a sign of uterine cancer.
Overview
What is postmenopausal bleeding?
Postmenopausal bleeding is bleeding that occurs after menopause. Menopause is a stage in a woman's life (around age 51) when reproductive hormones drop and her monthly menstrual periods end. Vaginal haemorrhage that occurs more than a year later on a adult female's last menses isn't normal. The bleeding can exist calorie-free (spotting) or heavy.
Postmenopausal bleeding is ordinarily due to benign (noncancerous) gynecological atmospheric condition such as endometrial polyps. Simply for nigh x% of women, bleeding later on menopause is a sign of uterine cancer (endometrial cancer). Uterine cancer is the almost mutual type of reproductive cancer (more mutual than ovarian or cervical cancers.) Talk to your healthcare provider if you experience any bleeding after menopause.
Who is more than probable to take postmenopausal bleeding?
Anyone tin can have vaginal bleeding, especially during perimenopause. Perimenopause, the time leading up to menopause, normally occurs betwixt ages twoscore and l. It's the phase when a woman's hormone levels and periods starting time to modify.
How common is postmenopausal bleeding?
Postmenopausal bleeding occurs in about 10% of women over 55.
Symptoms and Causes
What causes postmenopausal bleeding?
The most common causes of bleeding or spotting later on menopause include:
- Endometrial or vaginal atrophy (lining of the uterus or vagina becomes thin and dry).
- Hormone replacement therapy (HRT) (estrogen and progesterone supplements that decrease some menopausal symptoms).
- Uterine cancer or endometrial cancer (cancer in the lining of the uterus).
- Endometrial hyperplasia (the lining of the uterus gets too thick and can comprise aberrant cells).
- Uterine polyps (growths in the uterus).
Other causes can include:
- Cervical cancer (cancer in the cervix).
- Cervicitis or endometritis (infection or inflammation in the cervix or uterus).
- Bleeding from other areas, nearby, in the bladder or rectum or bleeding from the pare of the vulva (exterior nigh the vagina).
Diagnosis and Tests
How practise you know the cause of postmenopausal bleeding?
- Identifying the cause of the haemorrhage tin can include the following:
- Exam by your provider of the vagina and neck.
- Pap smear to cheque the cervical cells.
- Ultrasound, usually using a vaginal arroyo, which may include the use of saline to make it easier to run across any uterine polyps.
- Biopsy of the endometrium or uterus. In this procedure, your healthcare provider gently slides a pocket-size, straw-like tube into the uterus to collect cells to run into if they are abnormal. This is washed in the office and can cause come cramping.
Management and Treatment
How is postmenopausal bleeding treated?
Handling for postmenopausal haemorrhage depends on its cause. Medication and surgery are the most common treatments.
Medications include:
- Antibiotics can treat nigh infections of the neck or uterus.
- Estrogen may help bleeding due to vaginal dryness. You can apply estrogen direct to your vagina as a foam, band or insertable tablet. Systemic estrogen therapy may come as a pill or patch. When estrogen therapy is systemic, it means the hormone travels throughout the body.
- Progestin is a synthetic course of the hormone progesterone. It can care for endometrial hyperplasia by triggering the uterus to shed its lining. Yous may receive progestin every bit a pill, shot, cream or intrauterine device (IUD).
Surgeries include:
- Hysteroscopy is a procedure to examine your cervix and uterus with a camera. Your healthcare provider inserts a hysteroscope (thin, lighted tube) into your vagina to remove polyps or other aberrant growths that may exist causing bleeding. This can be washed in the function for diagnosis. To remove any growths, hysteroscopy is often done in the operating room nether full general anesthesia.
- Dilation and curettage (D&C) is a procedure to sample the lining and contents of the uterus. Your healthcare provider may perform a D&C with a hysteroscopy. A D&C tin can treat some types of endometrial hyperplasia.
- Hysterectomy is a surgery to remove your uterus and cervix. Y'all may need a hysterectomy if you accept uterine cancer. Your healthcare provider can tell you about the different approaches to uterus removal. Some procedures are minimally invasive, then they utilise very small cuts (incisions).
Living With
When should I contact my doc?
Contact your healthcare provider if you lot experience vaginal bleeding:
- More than a yr afterward your last menstrual period.
- More than than a year after starting hormone replacement therapy (HRT).
A annotation from Cleveland Clinic
It's normal to accept irregular vaginal haemorrhage in the years leading up to menopause. But if you lot have bleeding more than than a year subsequently your terminal menstrual period, information technology'south time to see your healthcare provider. Information technology could be the result of a unproblematic infection or benign growths. Merely in rare cases, bleeding could exist a sign of uterine cancer.
Source: https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding
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