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What causes post menopausal bleeding?

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Posted on Wed, 9 Jul 2014
Question: Hi Dr Grief,
What, if anything can you tell me about post menopausal bleeding (vaginal). I have not gone in to see my gyn yet, as I wanted to get myself a bit educated. I am 62, with no gynecological history. Had 3 healthy children, all grown now. Anything to share? I have heavy bleeding and lower abdominal pain. What tests can I expect to receive?
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Answered by Dr. Rakhi Tayal (45 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
Post menopausal bleeding is a common problem however the most common cause is a problem with the endometrial lining of the uterus.
The other causes can be divided into gyneacological and non gynaecological. The most common gynaecological causes would be vaginal atrophy or dryness or problems related to the cervix.
The vaginal dryness would respond to topical estrogen replacement creams and a pap smear would be able to assess the state of the cervix to determine if there are any problems with it.
Lesions of the ovary can also cause this symptom and this can be detected on ultrasound.
In terms of non gynaecological causes, this is not as common but has been documented in the medical literature.
The possible cause is most commonly infiltration of a lesion into the vaginal area. There have been cases where the bleeding was related to lesions that would have originated from the appendix, the kidney and a lady where the bleeding was related to a lymphoma.
These are rare scenarios but are possibilities.

This is not meant to alarm, if it has I apologize. You will have to visit your doctor for a detailed assessment which may include a pap sear a comprehensive imaging endometrial biopsy and blood investigations (full blood count, ESR (checks for inflammation), kidney blood tests such as creatinine. CEA)

Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Rakhi Tayal

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Practicing since :2001

Answered : 13885 Questions

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What causes post menopausal bleeding?

Brief Answer: Details below. Detailed Answer: Hello, Thanks for trusting us with your health concern. Post menopausal bleeding is a common problem however the most common cause is a problem with the endometrial lining of the uterus. The other causes can be divided into gyneacological and non gynaecological. The most common gynaecological causes would be vaginal atrophy or dryness or problems related to the cervix. The vaginal dryness would respond to topical estrogen replacement creams and a pap smear would be able to assess the state of the cervix to determine if there are any problems with it. Lesions of the ovary can also cause this symptom and this can be detected on ultrasound. In terms of non gynaecological causes, this is not as common but has been documented in the medical literature. The possible cause is most commonly infiltration of a lesion into the vaginal area. There have been cases where the bleeding was related to lesions that would have originated from the appendix, the kidney and a lady where the bleeding was related to a lymphoma. These are rare scenarios but are possibilities. This is not meant to alarm, if it has I apologize. You will have to visit your doctor for a detailed assessment which may include a pap sear a comprehensive imaging endometrial biopsy and blood investigations (full blood count, ESR (checks for inflammation), kidney blood tests such as creatinine. CEA) Please feel free to discuss further. I will be glad to answer the follow up queries that you have. 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