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What Causes Post Menopausal Bleeding?

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Posted on Tue, 27 May 2014
Question: My mother 54 has diabetes from 10 years. Got operated for carbuncle nearly 2 months ago. Wound has almost healed. Her sugar is under control 100-140 mg/dl. She got her periods in last May 2013 and was not having any since then. Yesterday she got them again. Normal and no heavy flow. Is it ok. Any suggestions?
doctor
Answered by Dr. Aarti Abraham (15 minutes later)
Brief Answer:
not ok, needs investigations

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Since your mother was not having any periods since year, technically she was menopausal.
Hence the ' period ' this time counts as post menopausal bleeding.
Coupled with a history of diabetes, this warrants investigation.
Please consult a gynecologist.
Go for a thorough internal evaluation - per vaginum and per speculum, and a pelvic ultrasound scan done transvaginally.
Also the following tests should be done -
FSH, LH, TSH, Prolactin, FBS, PPBS, HBA1c, Serum estradiol.
This workup is essential.
It will establish -
1. Whether she is truly menopausal.
2. Whether she is having conditions such as endometrial hyperplasia ( thickening of the lining of the uterus ), fibroids, cysts etc which can cause such a picture.
3. A pap smear also should be done at her age.
All the best
Please feel free to discuss further.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Aarti Abraham (26 hours later)
Hello thanks for your reply.
Went to her gynac, she checked her vagina and suggested sonography of pelvis.
Her report was normal, mentioning uterus and ovaries are normal. No cysts, polyps or abnormal endometrium.
She said it might be because of hormonal changes and medicines she has taken.
Today her flow isalmost on verge of stopping.
Do let me know your view on the attachments. Thank you.
doctor
Answered by Dr. Aarti Abraham (11 hours later)
Brief Answer:
AS BELOW

Detailed Answer:
Hello again.
THe ultrasound report is absolutely normal.
As the internal exam is also normal, do not worry.
Once her bleeding stops. please take a Cervical Pap smear examination also.
Otherwise, nothing needs to be done.
Just ensure that her blood sugars and weight are kept in check.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Causes Post Menopausal Bleeding?

Brief Answer: not ok, needs investigations Detailed Answer: Hello Thanks for writing to us with your health concern. Since your mother was not having any periods since year, technically she was menopausal. Hence the ' period ' this time counts as post menopausal bleeding. Coupled with a history of diabetes, this warrants investigation. Please consult a gynecologist. Go for a thorough internal evaluation - per vaginum and per speculum, and a pelvic ultrasound scan done transvaginally. Also the following tests should be done - FSH, LH, TSH, Prolactin, FBS, PPBS, HBA1c, Serum estradiol. This workup is essential. It will establish - 1. Whether she is truly menopausal. 2. Whether she is having conditions such as endometrial hyperplasia ( thickening of the lining of the uterus ), fibroids, cysts etc which can cause such a picture. 3. A pap smear also should be done at her age. All the best Please feel free to discuss further.