What is a post-menopausal bleed?
After the menopause the monthly bleeding stops. Menstruation with rejection of the uterine lining during the fertile menstrual cycle no longer takes place. If bleeding does occur after the menopause, the gynaecologist should be consulted as a precaution.
A bleeding after the menopause is a bleeding that has nothing to do with a lack of fertilisation of the egg cells. There are several possible causes of postmenopausal bleeding, ranging from harmless changes in the lining of the uterus to malignant changes in the tissue. Depending on the cause of the post-menopausal bleeding, the bleeding can be more or less intense and of varying length.
These are the causes
The causes of bleeding after menopause are often associated with changes in the lining of the uterus. Often the uterine lining is broken down by the hormone changes, which can cause bleeding. Occasionally, in contrast, there is an overproduction of endometrium.
A too high oestrogen level can lead to a thickening of the mucous membrane. This can also cause bleeding. With age, many women develop polyps or fibroids in the uterus.
These are benign tissue growths. Polyps are growths of the mucous membrane and fibroids are growths of the muscles of the uterus. Above a certain size, these benign tissue growths can also lead to postmenopausal bleeding in the uterus.
In addition, women can develop bleeding during hormone treatment. A pure therapy with oestrogen alone can lead to light, harmless bleeding, while combined preparations of oestrogen and progestin can cause period-like bleeding. In addition to the above-mentioned harmless causes of bleeding after menopause, the likelihood of malignant changes increases with age. Cervical cancer is a possible cause of bleeding after the menopause. To find out the cause and initiate appropriate treatment, you should always consult your gynaecologist if you have bleeding after the menopause.
Could this be an indication of (cervical) cancer?
Bleeding after the menopause can be an indication of a tumour in addition to harmless causes, for example cervical cancer or cervical cancer. Cervical cancer causes practically no or unspecific symptoms in the early stages and can become symptomatic in the advanced stages through bleeding. Cervical cancer can also cause bleeding postmenopausally, usually in the early stages. In order to rule out a malignant change in the uterus, a visit to the gynaecologist is strongly recommended in the case of bleeding after menopause. If a tumour is present, it is important for the prognosis to treat as early as possible.
Treatment of bleeding after menopause
The treatment of postmenopausal bleeding is determined by the cause of the bleeding. Colpitis senilis, an inflammation of postmenopausal women due to estrogen deficiency, can be treated by treating the mucous membrane locally with the hormone estrogen. If the postmenopausal bleeding is based on an elevated oestrogen level, oestrogen therapy can be used to reduce the oestrogen level in order to relieve the symptoms.
If uterine fibroids are the cause of post-menopausal bleeding, various treatment options may be considered depending on the location and size of the fibroids. There are medicinal and surgical treatment options for myomas. Malignant changes in the uterus are treated depending on the size, location and other criteria. Combined surgical procedures, radiotherapy and chemotherapy are considered.
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