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Postmenopausal Bleeding - Is It Normal?

MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Agra
Postmenopausal Bleeding - Is It 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 examination
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 a year of menopause, do not ignore it.
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After masturbation next morning I saw blood clot from my vagina and feel pain under my lower belly. During that night I feel so pain in my head. It happened two more time after masturbation.

BHMS, Diploma in Dermatology
Sexologist, Hyderabad
Women with large fibroids may feel heaviness or pressure in their lower abdomen or pelvis. Often this is described as a vague discomfort rather than a sharp pain.
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I am 12 years old. I have a problem called hemofilia, factor 13 deficiency. What is the temporary or permanent solution in ayurvedic treatment for this problem.

MD - Homeopathy, BHMS
Homeopath, Vadodara
I am 12 years old. I have a problem called hemofilia, factor 13 deficiency. What is the temporary or permanent soluti...
Hemofilia has no cure, so no temporary or permanent solution. You can do about it to be careful. Avoid any injury or bleeding.
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Wife is bleeding after 1st sex from last two days when she uses toilet or walk around.

MD - Obstetrtics & Gynaecology, FMAS, DMAS, Fellowship in Assisted Reproductive technology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Noida
Wife is bleeding after 1st sex from last two days when she uses toilet or walk around.
Hello , This is likely due to hymenal rupture after first intercourse and shall subside in 3-5 days , just keep the local area clean and wash regularly .
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My daughter is 11. 5 years old. She had her first period but after 8 days bleeding is not stopped. Should I give her medicine to stop the bleeding.

MBBS Bachelor of Medicine and Bachelor of Surgery, DGO
Gynaecologist, Pune
My daughter is 11. 5 years old. She had her first period but after 8 days bleeding is not stopped. Should I give her ...
If the bleeding is heavy, you need to give medicines to stop the bleeding. Your gynaecologist will help you with this problem.
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I am having spotting since last 7 days. My doctor recommended me cream ncr tablet. Does this tablet stop bleeding. Till how many days should I take?

BHMS
Homeopath, Noida
I am having spotting since last 7 days. My doctor recommended me cream ncr tablet. Does this tablet stop bleeding. Ti...
Yes Crina-NCR 10 mg Tablet is used in heavy menstrual bleeding, pain during menstruation, endometriosis.
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I am 21 years old. I had sex with my boyfriend 2 days ago. I saw a few drops of blood today morning .What it signifies?

MD-Ayurveda, Bachelor of Ayurveda, Medicine & Surgery (BAMS)
Sexologist, Haldwani
I am 21 years old. I had sex with my boyfriend 2 days ago. I saw a few drops of blood today morning .What it signifies?
Hello- Bleeding can be a sign of an infection, such as pelvic inflammatory disease (PID), or a sexually transmitted infection (STI), such as chlamydia, or can be due to vaginal dryness (atrophic vaginitis) caused by reduced vaginal secretions.
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I am 24 years old. I recently had unprotected sex. I took i-pill after 48 hrs. While having second time sex I had bleeding I that my periods started. But after two days I am feeling pain while urinating. The pain is as if something is pulling inside.

BHMS, Diploma in Dermatology
Sexologist, Hyderabad
I am 24 years old. I recently had unprotected sex. I took i-pill after 48 hrs. While having second time sex I had ble...
Painful urination is a common sign of a urinary tract infection (UTI). Any of these organs can cause pain during urination.
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Me and my fiancee had sex on 23 I withdrawn out before ejaculation and my she took ipill in next 1 hour her next period date was 12 nov but it started lighter bleeding on 7 nov and 8 nov and than stopped than again it started bleeding on 16 nov very lighter bleeding can I know what is this going on?

MBBS, MS - Obstetrics and Gynaecology, MRCOG
Gynaecologist, Kolkata
Me and my fiancee had sex on 23 I withdrawn out before ejaculation and my she took ipill in next 1 hour her next peri...
Get urine test for Pregnancy if she misses her next period. Every medicine has its own side effects. Do not take any medicine without supervision of a Gynecologist.
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Hi Doctor, My friend had 2 months pregnancy. She abort it by taking Mifepristone but vaginal bleeding is not stopping from 1 month. Please advice what to do.

MS - Obstetrics and Gynaecology
Gynaecologist, Delhi
She should do her urine pregnancy test, if test is positive it means abortion is incomplete, and she should get an ultrasound done. Further treatment will depend on ultrasound report. If urine pregnancy test is negative then she will have to take Medicines to stop bleeding.
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