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Is heavy bleeding in post-menopausal period a cause for concern?

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Posted on Fri, 6 May 2016
Question: I'm a 50 year old woman having had no menstrual bleeding with exception of the occasional spotting for many months. Now, I've been having some serious stress in my life, and have been bleeding heavily ie. changing a super tampon or large pad every hour to 1 1/2 hr. for 4 days. At what point should I begin to be concerned? C
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Answered by Dr. S Patra (45 minutes later)
Brief Answer:
Needs to be concerned. Do TVS scan.

Detailed Answer:
Hello,

Thanks for writing to us.

Heavy bleeding in post-menopausal period needs to be concerned. It may be due to hormonal imbalance, associated with dysfunction of ovary and progesterone deficiency.

Here, we need to rule out possible causes of this type of bleeding. These are as follows:

1) Endometrial atrophy (thinned out) or vaginitis
2) Endometrial hyperplasia (if any)
3) Endometrial cancer - High risk in postmenopausal bleeding.
4) Others- Cervical polyp, infection, adenomyosis, certain medication etc.

Complete physical examination including pelvic/ speculum exam and Colposcopy if indicated, is needed to rule out underlying pathology.

Some investigations are required to pinpoint the diagnosis like FSH, estrogen level, thyroid profile, Trans Vaginal Ultrasound scan (TVS), Pap smear test (to detect cancerous changes) and endometrial biopsy.

TREATMENT: Initiation of hemostatic agent combined with progesterone pill if the case is endometrial atrophy or hyperplasia. Though periodic monitoring of ET is needed.

In failed case, approach would be surgical by Operative hysteroscopy to remove polyp (if anything), endometrial ablation in case of hyperplasia.

Kindly, consult with your Gynecologist regarding this for proper management of the case.

Hope I have answered your query. If you don't have any other query, you can close the discussion.

Wish your good health and take care.

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Answered by
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Dr. S Patra

OB & GYN Specialist

Practicing since :2011

Answered : 4048 Questions

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Is heavy bleeding in post-menopausal period a cause for concern?

Brief Answer: Needs to be concerned. Do TVS scan. Detailed Answer: Hello, Thanks for writing to us. Heavy bleeding in post-menopausal period needs to be concerned. It may be due to hormonal imbalance, associated with dysfunction of ovary and progesterone deficiency. Here, we need to rule out possible causes of this type of bleeding. These are as follows: 1) Endometrial atrophy (thinned out) or vaginitis 2) Endometrial hyperplasia (if any) 3) Endometrial cancer - High risk in postmenopausal bleeding. 4) Others- Cervical polyp, infection, adenomyosis, certain medication etc. Complete physical examination including pelvic/ speculum exam and Colposcopy if indicated, is needed to rule out underlying pathology. Some investigations are required to pinpoint the diagnosis like FSH, estrogen level, thyroid profile, Trans Vaginal Ultrasound scan (TVS), Pap smear test (to detect cancerous changes) and endometrial biopsy. TREATMENT: Initiation of hemostatic agent combined with progesterone pill if the case is endometrial atrophy or hyperplasia. Though periodic monitoring of ET is needed. In failed case, approach would be surgical by Operative hysteroscopy to remove polyp (if anything), endometrial ablation in case of hyperplasia. Kindly, consult with your Gynecologist regarding this for proper management of the case. Hope I have answered your query. If you don't have any other query, you can close the discussion. Wish your good health and take care. For future query, you can directly approach me through http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326