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Postmenopausal Bleeding

Bleeding that recurs after menopause must always have the endometrium evaluated.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Postmenopausal Bleeding?

Postmenopausal bleeding is defined as any vaginal bleeding that recurs at least 12 months after the last menstrual period. Causes include atrophic endometritis/vaginitis, polyps, hyperplasia, endometrial cancer, hormone replacement therapy and cervical pathologies.

Endometrial cancer is detected in approximately 10% of postmenopausal bleeding cases; therefore each case must be evaluated carefully. Endometrial thickness measurement on transvaginal ultrasound is the first-step examination; endometrial sampling is indicated above 4 mm.

Treatment is planned according to the cause: atrophic changes are managed with topical estrogen, polyps with hysteroscopy, hyperplasia with progesterone therapy, and cancer with surgery + adjuvant therapies.

Symptoms

Bleeding that resumes after menopause
Pink or brown spotting
Postcoital bleeding
Watery foul-smelling discharge
Pelvic pressure or pain
Weight loss and weakness (in malignant disease)

Risk Factors

Obesity
Diabetes and hypertension
Nulliparity or late menopause
Tamoxifen use
Unopposed estrogen use
Lynch syndrome

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When bleeding occurs for the first time after menopause
  • When postcoital bleeding is noticed
  • When abnormal discharge and pelvic pain are added
  • When unexpected bleeding occurs while using HRT
  • For control if there is a previous diagnosis of endometrial pathology

Treatment Methods

01
Endometrial assessment with transvaginal ultrasound
02
Endometrial sampling with Pipelle or hysteroscopy
03
Topical estrogen for atrophy
04
Hysteroscopic polypectomy for polyps
05
Progestin or surgery in hyperplasia
06
Oncologic surgery and adjuvant therapy if cancer is detected

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.