Postmenopausal Bleeding

Menopause is a a normal part of aging in women. Menopause is the cessation of menstruation. This occurs because a women's ovaries run out of functioning eggs. Women are born with between 1 and 3 million eggs which she loses during her lifetime. As menopause draws nearer the ovaries produce less estrogen which doctors believe causes the symptoms associated with menopause. The ovaries also produce less testosterone a hormone involved in the sex drive.

Once a woman has stopped having her menstrual cycle for a year she is considered to have completed menopause. If a woman then has bleeding even just a little spotting this is not normal and should be checked by a doctor as there can be several reasons why this is occurring.

Some of the conditions that cause postmenopausal bleeding are polyps,Endometrial atrophy which is thinning of the endometrium, Endometrial hyperplasia which is the lining of the uterus becomes thick,or Endometrial cancer. The cause of menopausal bleeding must be determined as some of these conditions are serious.

There are several tests to determine the cause of your postmenopausal bleeding.Your doctor will decide which test he believes you need after taking your history and doing a physical exam.

A Transvaginal Ultrasound is a test where a device much similar in width to a tampon but longer is inserted into the vagina so that your doctor can see your pelvic organs and any abnormalities that may be there.

Endometrial biopsy is a test where a thin tube is inserted into the uterus so that a sample of the lining can be removed for testing at a lab.

Hysteroscopy a device with a light and camera is inserted into the vagina so the doctor can check for abnormalities.

D & C which stand for dilation and curettage is a test where the doctor removes tissue from the uterus lining for testing in a lab.

Depending on what your diagnosis is will depend on what treatment your doctor decides on.

If you have polyps surgery may be needed to remove them. Polyps are usually noncancerous. Endometrial atrophy can be treated with medication while Endometrial hyperplasia can be treated with medication and or surgery to remove the thickened areas of the lining. Endometrial cancer can be treated with surgery for a total hysterectomy and possibly radiation and chemotherapy depending on the severity of the cancer. 

Less than a month ago I finished my 5 year tamoxifen prescription for my high risk of breast cancer and it was time for my yearly ob/gyn exam. Questions were asked and I have had no menstrual cycle for more than a year and then had some bleeding. Oh boy. So my doctor ordered a transvaginal ultrasound for me. I was not looking forward to this, thinking again how awful to go through this degrading test, as is the pap smear. I really didn't want to do this as the whole sound of it is in no way appealing. So before my test of course I told the girls on my bowling team that I was going to have this procedure done, and girls will talk and joke and joke they did. I heard all the horror stories about the inserted instrument was as long as a baseball bat and every other story they could tell me to get a laugh. This did not help my attitude when the day arrived for me to have the test. Firstly I had to have a full bladder as any woman who ever had an ultrasound knows, and it just seems when you have to have a full bladder it just seems you have to go, more urgently than normally if you know what I mean. So first they do a regular ultrasound with the jelly on the belly thingy. Then thankfully they let me empty my bladder. Then came the part I was dreading. I had a sheet over me and the tech was holding the wand as they called it, she place the wand under the sheet and asked me to insert it as I would a tampon, she was watching the ultrasound screen as I inserted the wand and then told me to stop. I only inserted it about an inch or so much less than a tampon. All the while she was still holding onto the wand. Then she barely moved it and got all the pictures she needed, and never was I uncovered or exposed to her. It was not as degrading as a pap smear. So now I have to have the Endometrail biopys as they found some thickening of the lining. They told me that I would have some cramping for a couple of minutes as the biopsy was being done. We shall see as I haven't had that yet. Oh it's so wonderful being a woman!!!