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Postmenopausal Bleeding - Is It Considered As Normal?

MS- Gynaecology
Gynaecologist, Jaipur
Postmenopausal Bleeding - Is It Considered As Normal?
Most women attain menopause between the ages of late 40s and early 60s, the average age being about 51. This is an important milestone in a women-s gynecological history. One major change is altered female hormone levels, and this leads to a lot of physiological changes. From hot flashes to mood swings, there is also increased predisposition to osteoporosis and uterine cancer.

If you have not had your menstrual cycles for close to 12 months, chances are you are into menopause. So, that means absolutely no vaginal bleeding anymore whatsoever. However, if you experience bleeding, even spotting, be on the alert. It is not normal and needs to be examined, and if required, diagnosed and treated.
Postmenopausal bleeding or PMB as it is popularly called can be due to a variety of reasons. While it could be something as trivial as inflammation of the uterine or vaginal lining, it could also be an indication of more severe issues like cancer.

- Atrophic vaginitis - Decreasing hormonal levels lead to increased dryness and therefore inflammation of the vaginal and uterine tissue. This is one of the common causes of bleeding after menopause.
- Endometrial atrophy - Also caused by lower hormone levels, the lining of the body of the uterus gradually thins down and can get inflamed.
- Polyps - Noncancerous growths in the uterus, cervix, vulva, or vagina can also lead to bleeding
- Infections - General infection of any area along the uterine tract could lead to occasional bleeding
- Cancers - Though only 1 in 10 PMB cases turn out to be cancers, the prognosis improves with early diagnosis and intervention.
Diagnosis: As repeated above, reach out to your doctor if you notice postmenopausal bleeding. Diagnostic methods could include the following:
- Physical exam
- Transvaginal ultrasound
- Endometrial biopsy
- Hysteroscopy
- Dilatation and Curettage


Treatment: Needless to say, this would depend on the diagnosis.
For very minor cases with diagnosis like altered hormone levels, no treatment may be required other than modification of the hormone replacement therapy.

For endometrial atrophy and atrophic vaginitis, use of estrogen creams and pessaries would be sufficient.
Polyps would require removal followed by cauterization (application of slight heat) to stop the bleeding.
Cancer - this would depend on the type and location and require a combination of chemotherapy and surgery. Removal of the uterus also may be required in some cases.
So, if you have had bleeding of any sort after ayear of menopause, do not ignore it.
4211 people found this helpful

I am 27 year old. I have 1daughter. 25 days se mujhe continue black bleeding ho rahi hai. Mei kya karu bhut problem ho rahi hai.

DHMS (Hons.)
Homeopath, Patna
I am 27 year old. I have 1daughter. 25 days se mujhe continue black bleeding ho rahi hai. Mei kya karu bhut problem h...
Hi, Lybrate user, take, plenty of water to hydrate your body. Your diet be easily digestible on time. Monitor your weight, please. Take, homeopathic medicine:@ kreosote 30-5 drops, thrice. Take, care.
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I am 20 years old girl had sex with my partner 6 days ago but after that continuous bleeding is occurred from vagina (its not a first time sex) and back pain is also there so I want to know this is this normal or any serious problem?

MD-Ayurveda, Bachelor of Ayurveda, Medicine & Surgery (BAMS)
Sexologist, Haldwani
I am 20 years old girl had sex with my partner 6 days ago but after that continuous bleeding is occurred from vagina ...
Hello- if the sex was rough and unlubricated, then it is normal to bleed sue to friction, but if not, then better go for a pelvic ultrasound to rule out any cyst or fibroid in your reproductive pathway.
2 people found this helpful
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Menorrhagia - Everything About It!

MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Obstetrics & Gynaecology
Gynaecologist, Delhi
Menorrhagia - Everything About It!
Menorrhagia is menstrual condition characterized by an abnormal loss of blood or heavy, prolonged bleeding. Although heavy bleeding is not uncommon in premenopausal women, menorrhagia is a severe condition which generally interferes with your daily activities. If your vagina bleeds irregularly or between periods, in addition to such heavy bleeding that at least one pad or tampon gets soaked every few hours, it is highly recommended that you seek medical attention.

Symptoms:

Signs and symptoms of menorrhagia include:

Soaking through more than one tampon or sanitary pad for every few hours
The need to use double sanitary protection
Heavy bleeding for weeks on end
The need to wake up at night to change your sanitary protection
Restriction of daily activities due to heavy menstrual flow
Symptoms of fatigue, such as excessive tiredness as well as shortness of breath
Causes:

Although the exact causes are unknown, here are a few causes that may be responsible:

Hormonal imbalance is when there is an hormone imbalance, the endometrium develops in excess and sheds away with menstruation
In Ovary dysfunction, if your ovaries do not ovulate, your body won't be able to produce the hormone progesterone resulting in a hormonal imbalance problem which may lead to menorrhagia
Uterine fibroids are benign tumors which start appearing in your childbearing years
Polyps are small benign growths found on the uterine lining
Adenomyosis occurs when your glands from the endometrium becomes embedded in the uterine muscle
By using Intrauterine device (IUD) menorrhagia may occur as a side-effect
Pregnancy complications, for instance, an ectopic pregnancy can cause it
Inherited bleeding disorders, such as von Willebrand disease
Certain medications like anti-inflammatory drugs
Other medical conditions, like pelvic inflammatory disease or endometriosis
Treatment:

Treatment for menorrhagia depends on a number of factors like the cause and severity of the condition, or your tolerance for specific therapies or medications.

Some drug therapies for menorrhagia include:

Iron supplements
Tranexamic acid
Oral progesterone
Non steroidal anti-inflammatory drugs
Oral contraceptives
Hormonal IUD
If drug therapy is ineffective, other treatment options may include:

Dilation and curettage
Focused ultrasound ablation
Uterine artery embolization
Endometrial ablation
Myomectomy
Endometrial resection
Hysterectomy
5063 people found this helpful

Hi, I tends to spot very light brown for 1-2 days then having nothing for 3-4 days then start bleeding. For my ovulation time how do I start counting on the day right having brown spotting or when I start bleeding?

International Academy of Classical Homeopathy, BHMS
Homeopath, Pune
Hi, I tends to spot very light brown for 1-2 days then having nothing for 3-4 days then start bleeding. For my ovulat...
You are suffering from harmonal imbalance take below treatment sepia 12c 3tims day for 10 days puls 12c 3tims day for 10 days.
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I face some blood coming out during my urination in the morning. I had intercourse with my husband 3 days ago and that was our first experience of sex.

BHMS
Homeopath, Noida
I face some blood coming out during my urination in the morning.
I had intercourse with my husband 3 days ago and tha...
When was your last period. If you intercourse within 2-3 days after periods, then its normal. Consult online with details.
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My question I have bleeding problem last year I scanned fibroid is there so I am taking homeopathy medicine but every month 20 days my period stars and heavy flow. Please suggest me.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
My question I have bleeding problem last year I scanned fibroid is there so I am taking homeopathy medicine but every...
Dear user. I can understand. Please don't be panic but be serious about the symptoms. I sincerely request you not to try alternative medicines when your health is at stake. Consult your gynecologist for physical investigation. Please provide more information so that we can start the diagnosis process and the treatment. I am here to help you in every aspect of your mental and physical health. Any sexual or psychological problems can be cured with the help of various methods and therapies. I suggest you to post your query with every detail here. I will help you in overcoming your problems certainly. Take care.
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I was on depo for about 1.5 years and have been off it now for about 3 months im taking no other contraception. I have had 2 occasions of very light bleeding which only last 2 days both occasions were 23 days apart. I was curious as to when my periods will return back to a normal flow and if there is a chance I am still fertile even with only light bleeding?

MD - Homeopathy, BHMS
Homeopath, Vadodara
I was on depo for about 1.5 years and have been off it now for about 3 months im taking no other contraception. I hav...
You need to go under some tests to find out about your fertility and menstrual cycle even with light bleeding. Without reports it is not possible to suggest you anything. You can consult me through Lybrate for homoeopathic treatment and further guidance about reports.
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I had laparotomy in december but I travelled 60 km now i'm having bleeding is it worry about or not.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Jaipur
I had laparotomy in december but I travelled 60 km now i'm having bleeding is it worry about or not.
Apply ice pack to stop bleeding. Raktastambhak vati (dhootpapeshwar) 2 tb twice a day empty stomach.
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