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Dr. Andrew Rynne

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What causes post menopausal bleeding?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 10993 Questions

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Posted on Wed, 21 Oct 2015 in Women's Health
Question: I have postmenopausal bleeding since aug4/15 till yesterday. My doc sent me for ultrasound and the results were: endometrius thicking upto 16mm with heterogenous ultrasound texture and abnormal increasse in vascularity on color doppler flow image. Small 5mm fibroid. Then my gyno did an endometrial biopsy and the results came as: small benign endometrial type polyp. Background endometrium with atrophy. Negative for hyperplasia and malignancy. Gyno sent me back to my fam.doct who now told me to wait and see if bleeding will stop. Can you shed further light on this matter. Thanks.
doctor
Answered by Dr. Michelle Gibson James 24 minutes later
Brief Answer:
non cancerous lesion

Detailed Answer:
HI, thanks for using healthcare magic

Post menopausal bleeding can be concerning because of the potential risk of endometrial cancer.

This is the reason that your doctors would have suggested the ultrasound and biopsy, these were done to rule out cancer as a cause.

This has been ruled out based on the results stated above. According to your biopsy, a polyp was seen but it is benign (non cancerous).

A polyp is an outgrowth or protrusion of an area, in this case the endometrium (internal lining of the uterus).

A medical study (can provide name of med journal if wish to review) , followed some women with polyps and found that many improved on their own , some resolved completely, others stayed the same size.
In only a small percentage (16%) , was there an increase.

This is the reason for the watch and wait approach, it is quite possible that your polyp would decrease in size on its own and your symptoms resolve.

If the bleeding is disruptive, your doctor can suggest medications to help decrease it though removal of the polyp (if bleeding very bothersome) would be the best option.

There is a low rate of progression from benign to malignant but your doctors will monitor to follow this up

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 23 minutes later
Thanks for your answer. Generally how long will this polyp bleed in this instance, since I have been bleeding sometime with clots since Aug4/15. If the bleeding stops and it starts again after a while do I see the gyno again, and do you think hysterectomy will be good to avoid bleeding and fear of cancer in future. Thanks.
doctor
Answered by Dr. Michelle Gibson James 35 minutes later
Brief Answer:
may lasts for over 6 months

Detailed Answer:
HI

Bleeding since August is difficult. Bleeding can continue for many months as long at the polyp remains. In some persons 6 months or more, it varies from one person to the next.

May consider polypectomy first, this is removal of the polyp since the polyp is the source of the bleeding.
Over 90 % are benign so you can of cancer or progression is really low but I can understand being anxious about it.

I would not consider a major op like hysterectomy at this point but in the end it is your decision

If anything else unclear feel free to ask


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James 1 hour later
Thanks again for your quick response. As mentioned by you in your response above, can you give me the name of the medical journal, a study that was done to review endo polyps ? Thank you.
doctor
Answered by Dr. Michelle Gibson James 33 minutes later
Brief Answer:
no prob

Detailed Answer:
Hi

No prob

It was an article in medscape medical news though also published in XXXXXXX institute of ultrasound in medicine mentioned at their 2011 convention.
Dr Harman, Dr XXXXXXX and Dr Kaunitz

Title in medscape medical news is Are endometrial polyps overtreated?

In XXXXXXX institute of ultrasound in medicine-abstract 939528 and 981597

Hope this helps. Can let me know if need to.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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