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What causes heavy bleeding in post-menopausal period?

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Posted on Wed, 30 Jul 2014
Question: Post menopusal 63 lady. I had a D and C, 1.5 years ago because of bleeding. All test were ok no cancer. Recently Im haveing alot of bleeding every few weeks.No pain. It stops and starts. Some passing dark clots, then bright red blood.
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Answered by Dr. S Patra (1 hour later)
Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for writing to us.

Heavy bleeding (On/ Off) in post-menopausal period may be due to hormonal imbalance, caused by dysfunction of ovary and progesterone deficiency.

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

1) Endometrial atrophy (thinned out)
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 the means of D & C, 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 yourself.

Regards,
Dr Soumen.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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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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What causes heavy bleeding in post-menopausal period?

Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for writing to us. Heavy bleeding (On/ Off) in post-menopausal period may be due to hormonal imbalance, caused by dysfunction of ovary and progesterone deficiency. However, we need to rule out possible causes of this type of bleeding. These are as follows: 1) Endometrial atrophy (thinned out) 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 the means of D & C, 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 yourself. Regards, Dr Soumen.