Postmenopausal Bleeding

What is Postmenopausal Bleeding?

Postmenopausal bleeding is vaginal and/or genital bleeding in women who have already gone through the menopause process. It is often associated with neoplastic (abnormal tissue) formations and genital atrophy (change in size and structure). The bleeding is most likely to come from the uterus; however, it may come from other organs or tissues in the pelvic area.

What Causes Postmenopausal Bleeding?

Since postmenopausal bleeding can occur because of problems with organs and tissues other than the uterus, a thorough examination will be performed by your doctor to determine the exact cause. The most common reasons for bleeding to occur from the uterus are as follows:

• Medications - Hormone replacement therapy
• Cervical examination
• Surgery
• Trauma
• Reoccurrence of menstruation due to natural rise in hormone levels
• Neoplastic formations in the uterus and abdomen
• Thinning of the uterine lining

What Tests Are Performed To Determine The Source Of Bleeding?

Your doctor will ask you many questions about your menstrual history and general state of health. It is helpful to remember the date of your last regular menstrual cycle and when the current bleeding began. It is also important to disclose any medications you are or have recently taken. Your doctor may or may not perform the following tests:

• Blood test - anemia, hematocrit (blood cell count)
• Vaginal and Cervical Exam - lesions, atrophy, trauma and discharge
• PAP Smear
• Vaginal Swab - culture to determine infection
• Endometrial Sampling - biopsy of the uterine lining
• Ultrasound
• Hysteroscopy - internal exam of the uterus using a lighted scope

During a physical exam, your doctor will be looking at the size, position and mobility of the organs in your pelvis area. Report any pain that you may experience during any of the tests mentioned above.

What Can Be Done To Stop The Bleeding?

This will depend upon what is causing the bleeding. If medication is determined to be the cause, your doctor may change your prescription or have you stop taking it entirely. If the cause is due to changes in the uterine lining, procedures such as a D & C (dilatation and curettage) may be indicated. Your doctor will discuss your alternatives with you.