Help! I thought I was done with my periods!
Most of the time, Postmenopausal bleeding (PMB) is due to a harmless cause and is treatable. However, vaginal bleeding when you are menopausal is not considered normal and warrants careful investigation to rule out more serious causes.
Causes of postmenopausal bleeding may include:
- vaginal or endometrial atrophy (thinning of tissues)
- cervical or endometrial polyps
- thickening of the endometrium (hyperplasia)
- precancerous or cancerous changes of the vagina, cervix, or uterus
- pelvic trauma
- bleeding from the urinary tract or rectum
How is the cause of PMB determined?
- A history and physical examination
- A pelvic ultrasound
- Endometrial biopsy – a fine tube is passed through your cervix to obtain a specimen of tissue from the uterine lining (endometrium) and sent to the lab for testing
- Hysteroscopy – a thin instrument attached to a camera and light sourced is used to visualise the inside of the uterus.
- Dilatation & curettage (D&C) – a sample of endometrium is removed and sent to the lab for testing
Treatment of PMB
Treatment depends on the underlying cause.
- Atrophic vaginitis and thinning of the endometrium can be treated with vaginal estrogen
- Polyps are usually removed with surgery
- Endometrial hyperplasia can be treated with medications to thin the endometrium, or may require surgery
