Understanding Post-Menopausal Bleeding: Could It Be Gynecologic Cancer?

Menopause is a scenario when a woman has gone without a period in the last 12 months. As per professional doctors, there is no menstrual bleeding after menopause. But, if the bleeding happens after menopause, it is not a normal thing. You need to consult a healthcare professional even if it is spotting blood.

Most of the time, menstrual bleeding after menopause is due to some noncancerous growths, vaginal dryness, and other changes in the reproductive organs. But, in very rare cases, it can be cancer.

Let’s read ahead and find out how the patients can deal with it!

What is Post-Menopausal Bleeding?

When a female hasn't had a menstrual period in the last 12 months, it is known as menopause. Ideally, there is no bleeding after menopause, but if it happens, we need to consult a doctor.

Some of the symptoms of bleeding are blood spotting, heavy bleeding, pink or brown discharge, etc. In around 10% of females, post-menopausal bleeding can be a sign of Gynecologic cancer. The most common of them is the uterine cancer.

What Causes Post-Menopausal Bleeding?

Besides the few mentioned above, there are several other reasons for postmenopausal bleeding.

Uterine polyps: These are tissues that grow inside the uterus. They are not cancerous, but they can lead to blood spotting and heavy bleeding.
Endometrial atrophy: Endometrial atrophy is also a cause of Postmenopausal bleeding. The endometrium is a tissue that lines the uterus and responds to hormones like estrogen and progesterone. Ideally, these hormones are abundant, but after menopause, the hormone level decreases, leading to thinning of the lining and further bleeding.
Endometrial hyperplasia: This condition is exactly opposite to Endometrial atrophy. In this case, the lining of the uterus thickens due to too much estrogen and too little progesterone, which causes it to bleed. The thickening of the lining can lead to abnormal cells and cancer.
Vaginal atrophy: The health of the vaginal tissue is dependent on estrogen. But after Menopause, the estrogen level decreases, which makes the vaginal tissue dry, inflamed, and thin, ultimately leading to bleeding.
Cancer: This is by far the most dangerous symptom of postmenopausal bleeding. It can be due to uterine cancer, cervical cancer, or vulvar cancer.

Habits and Health Conditions of Those with Post-Menopausal Cancer?

There are some health conditions and habits of patients who face post-menopausal bleeding. Here are some of those risk factors.

Women with obesity are likely to face post-menopausal bleeding
Thyroid and diabetes patients are likely to face this issue
If a patient reaches menopause after a certain average age. The average age is 51 years.
Smoking is also a primary cause of post-menopause bleeding.
Patient with polycystic ovary syndrome (PCOS).

What are the Ways to Diagnose Post-Menopausal Cancer?

When visiting a healthcare professional, tell them all the symptoms your body is witnessing. Based on the symptoms, there are several ways to diagnose post-menopausal cancer.

Hysteroscopy: In this method, your uterus is examined to find the issue. For this, a device with a light and camera is inserted into the vagina into the uterus.
Dilation and curettage: This process involves enlarging of the uterus and scrapping the tissue from the lining to get it examined.
Endometrial biopsy: In this process, a thin tube is inserted into the uterus to remove a tiny lining sample. The sample is sent to the lab for testing and examination.
Transvaginal ultrasound: In this process, an advanced imaging device is inserted into the vagina to analyze the pelvic organs.
Pap smears: This method checks for irregular cells on the patient’s cervix.

How to Treat Post-Menopausal Bleeding?

When it comes to post-menopausal bleeding, there are several ways to manage and treat it. However, the choice varies based on the cause of the bleeding. Here is an overview of the treatments. The easiest way to treat post-menopausal bleeding is via medicines.

Antibiotics: Antibiotics can be of several types, primarily used to treat infections.
Estrogen: Providing enough estrogen to your vaginal tissue can help in reducing bleeding. Estrogen can either be taken as an application cream, ring, or an insertable tablet. Systematic estrogen therapy, like pills and patches, can lead to better vaginal health.
Progestin: In the case of a thick uterus lining, progestin in the form of cream, pills, and intrauterine device (IUD) can be provided to the patient to stop the bleeding. Besides these medications, there are other treatments too.
Hysterectomy: In case your diagnosis reveals uterine cancer, this surgery can treat it by removing the uterus and cervix.
D&C (dilation and curettage): In this method, the doctor uses a thin tool to remove polyps or thickened areas of the uterine lining that have resulted from endometrial hyperplasia.

Conclusion

This is all about bleeding after menopause. The first thing is that it is not normal. No matter the symptoms, the patient must consult a healthcare provider for the best advice. Based on the diagnosis and reason for bleeding, the healthcare provider will offer the required medication or treatment, thereby ensuring better health.

References

https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding
https://www.webmd.com/menopause/postmenopausal-bleeding