Post-Menopausal Bleeding

Postmenopausal bleeding
Post menopausal bleeding is vaginal bleeding that happens at least 12 months after your periods have stopped.
About 4 % of women suffer with the above problem.It is not normal to bleed after menopause and it has to be investigated.

Causes of post menopausal bleeding
Most common cause of post menopausal bleeding is atrophic vaginitis and atrophic endometritis.After menopause due to decrease in the level of harmones in the body there can be thinning and inflammation of the inner lining of the uterus.
Other causes of post menopausal bleeding are 
polyps they refer to the extra growths of the inner lining of the uterus as well as the neck of the uterus(cervix).
PMB can also be because of thickening of the inner lining of the uterus, also called as hyperplasia.it can be because of extraneous harmones or obesity.
Less than 10% of the woman who suffer from PMB may have cancer of endometrium ,cervix and vagina.

Diagnosis
1)Pelvic examination
your doctor will do an internal examination to examine the cervix and do a papsmear if it is due.
2)USG scan is done to note down the size of uterus and the thickness of the endometrium.based on these reports the doctor might decide about the further tests.

3)Endometrial biopsy a small tube will be inserted into the uterus and cells are collected and sent to lab to note if there is any thing abnormal .This is an office procedure.and ususlly does not require admission
4)Hysteroscopy it is a procedure where a small camera is put inside the uterus and a targetted biopsy taken from the suspicious area.

Treatment
The treatment of PMB depends upon the cause.
If endometrial atrophy was the reason it can usually be traeated with estrogen creams and pessaries
Cervical and endometrial polyps require surgery to remove them.Hysteroscopic polypectomy refers to the surgery where in the polyp is removed under the guidance of the camera which is inserted into the uterus.
Endometrial hyperplasia can be treated with progesterone tablets or progesterone impregnated intrauterine devices.
Endometrial cancer will have to be treated with surgery for the removal of uterus and ovaries.Some patients may require chemo or radiotherapy as the stage of cancer may demand.
All in all postmenopusal bleeding doesnt mean the patient has cancer 90 percent of the time it is because of the benign causes but it should not be ignored but investigated.Its betTer to be safe than sorry.