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Does vaginal bleeding require uterus removal in an elderly patient?

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Posted on Thu, 2 Aug 2018
Question: Hi,
My aunt is 61 years old and she is suffering from bleeding problems. She encountered menopause since 15 years. The first bleeding occurred last August 2017 and it was for 10 days. When consulted a doctor they suggested for Uterus removal. Please suggest the best that can be done.
P.S. She is diabetic and is on insulin.
doctor
Answered by Dr. Rakhi Tayal (16 minutes later)
Brief Answer:
Needs proper evaluation.

Detailed Answer:
Hello,
Thanks for posting your query.
At age 61, all bleeding from the uterus has to be taken very seriously. In women presenting with post menopausal bleeding, as many as 15% have pre-cancerous or cancerous changes of the uterus.
Here is exactly what needs to happen:
1. She needs a visit to a OB/GYN and an examination
2. During this exam they need to perform an endometrial biopsy and PAP smear
3. She then needs an ultrasound to look at the ovaries and the endometrial lining

If the biopsy is normal and the 'lining' of the uterus is 4mm or less, then there is absolutely no concern for cancer. In case a cancer is detected then surgical removal will be needed depending on the severity of the problem.

Of note, the most common cause of bleeding after menopause is related to the 'thinnin' and fragility of the lining of the uterus, followed by polyps of the uterus (which are common).

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Rakhi Tayal (1 hour later)
Hi Doc,

The Biopsy result is negative for the patient. The first bleeding occurred on last November, it was stooped after 10 days , again it happened on the month of January.
The local doctor said after CT scan and Ultrasound that it is due to bulky uterus and suggested for a removal of the organ. Please suggest.

I have attached the reports.
doctor
Answered by Dr. Rakhi Tayal (1 hour later)
Brief Answer:
Surgery can be avoided for bulky uterus.

Detailed Answer:
Hello.
Thanks for writing again.
I have seen all the attached reports. The endometrium shows cystic hyperplasia. Only bulky uterus is not an indication of hysterectomy and it does not cause a bleeding. If endometrial biopsy is normal then the bleeding can be due to fragile mucosa and the surgery can be avoided.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 13882 Questions

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Does vaginal bleeding require uterus removal in an elderly patient?

Brief Answer: Needs proper evaluation. Detailed Answer: Hello, Thanks for posting your query. At age 61, all bleeding from the uterus has to be taken very seriously. In women presenting with post menopausal bleeding, as many as 15% have pre-cancerous or cancerous changes of the uterus. Here is exactly what needs to happen: 1. She needs a visit to a OB/GYN and an examination 2. During this exam they need to perform an endometrial biopsy and PAP smear 3. She then needs an ultrasound to look at the ovaries and the endometrial lining If the biopsy is normal and the 'lining' of the uterus is 4mm or less, then there is absolutely no concern for cancer. In case a cancer is detected then surgical removal will be needed depending on the severity of the problem. Of note, the most common cause of bleeding after menopause is related to the 'thinnin' and fragility of the lining of the uterus, followed by polyps of the uterus (which are common). I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Rakhi Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal