Got Period Came Back Once and Then Went Away Again
Postmenopausal Bleeding
Postmenopausal bleeding is vaginal bleeding that occurs a year or more after your final menstrual period. It tin be a symptom of vaginal dryness, polyps (noncancerous growths) or other changes in your reproductive organisation. In nigh 10% of women, bleeding after menopause is a sign of uterine cancer.
Overview
What is postmenopausal bleeding?
Postmenopausal bleeding is haemorrhage that occurs after menopause. Menopause is a phase in a adult female's life (around age 51) when reproductive hormones driblet and her monthly menstrual periods end. Vaginal bleeding that occurs more than than a year subsequently a woman'southward last period isn't normal. The bleeding can be lite (spotting) or heavy.
Postmenopausal haemorrhage is usually due to benign (noncancerous) gynecological conditions such every bit endometrial polyps. But for nearly x% of women, bleeding after menopause is a sign of uterine cancer (endometrial cancer). Uterine cancer is the well-nigh mutual blazon of reproductive cancer (more common than ovarian or cervical cancers.) Talk to your healthcare provider if you experience whatsoever bleeding after menopause.
Who is more likely to accept postmenopausal bleeding?
Anyone tin have vaginal bleeding, especially during perimenopause. Perimenopause, the time leading up to menopause, usually occurs between ages xl and l. It's the phase when a woman's hormone levels and periods start to change.
How common is postmenopausal haemorrhage?
Postmenopausal haemorrhage occurs in nigh ten% of women over 55.
Symptoms and Causes
What causes postmenopausal bleeding?
The near mutual causes of haemorrhage or spotting afterwards menopause include:
- Endometrial or vaginal cloudburst (lining of the uterus or vagina becomes sparse and dry).
- Hormone replacement therapy (HRT) (estrogen and progesterone supplements that subtract 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 float or rectum or bleeding from the skin of the vulva (exterior nearly the vagina).
Diagnosis and Tests
How practise you lot know the cause of postmenopausal bleeding?
- Identifying the cause of the bleeding can include the following:
- Exam past your provider of the vagina and cervix.
- Pap smear to check the cervical cells.
- Ultrasound, usually using a vaginal approach, which may include the use of saline to make information technology easier to meet any uterine polyps.
- Biopsy of the endometrium or uterus. In this process, your healthcare provider gently slides a pocket-size, straw-like tube into the uterus to collect cells to run across if they are abnormal. This is done in the function and can crusade come cramping.
Management and Treatment
How is postmenopausal haemorrhage treated?
Handling for postmenopausal bleeding depends on its cause. Medication and surgery are the most mutual treatments.
Medications include:
- Antibiotics tin can treat most infections of the neck or uterus.
- Estrogen may help bleeding due to vaginal dryness. You can apply estrogen straight to your vagina as a cream, ring 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 class of the hormone progesterone. Information technology tin treat endometrial hyperplasia by triggering the uterus to shed its lining. Yous may receive progestin equally a pill, shot, cream or intrauterine device (IUD).
Surgeries include:
- Hysteroscopy is a procedure to examine your neck and uterus with a photographic camera. Your healthcare provider inserts a hysteroscope (thin, lighted tube) into your vagina to remove polyps or other aberrant growths that may be causing bleeding. This can exist 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 neck. Y'all may need a hysterectomy if you have uterine cancer. Your healthcare provider can tell you lot nigh the different approaches to uterus removal. Some procedures are minimally invasive, then they use very small-scale cuts (incisions).
Living With
When should I contact my doctor?
Contact your healthcare provider if you experience vaginal bleeding:
- More than a twelvemonth after your last menstrual period.
- More than than a year subsequently starting hormone replacement therapy (HRT).
A notation from Cleveland Clinic
It'due south normal to accept irregular vaginal bleeding in the years leading up to menopause. Merely if you take bleeding more than a year after your last menstrual period, it's time to see your healthcare provider. It could be the result of a elementary infection or benign growths. Only in rare cases, bleeding could be a sign of uterine cancer.
Source: https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding
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