Hormone: Substance made in the body that controls the function of cells or organs. Hormone Therapy: Treatment in which estrogen and often progestin are taken to help relieve symptoms that may happen around the time of menopause. Lymph Nodes: Small groups of special tissue that carry lymph, a liquid that bathes body cells. Lymph nodes are connected to each other by lymph vessels. Together, these make up the lymphatic system.
Menopause is confirmed after 1 year of no periods. A menstrual cycle is defined as the first day of menstrual bleeding of one cycle to the first day of menstrual bleeding of the next cycle. Menstrual Periods: The monthly shedding of blood and tissue from the uterus. Ovaries: Organs in women that contain the eggs necessary to get pregnant and make important hormones, such as estrogen, progesterone, and testosterone.
Polyps: Abnormal tissue growths that can develop on the inside of an organ. Progesterone: A female hormone that is made in the ovaries and prepares the lining of the uterus for pregnancy.
Progestin: A synthetic form of progesterone that is similar to the hormone made naturally by the body. Stage: Stage can refer to the size of a tumor and the extent if any to which the disease has spread. Tamoxifen: An estrogen-blocking medication sometimes used to treat breast cancer. Transducer: A device that sends out sound waves and translates the echoes into electrical signals.
Ultrasound Exam: A test in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasound can be used to check the fetus. Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body. Copyright by the American College of Obstetricians and Gynecologists.
All rights reserved. Read copyright and permissions information. This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician.
It is not normal to have bleeding or spotting between periods bleeding or spotting after sex heavy bleeding during your period bleeding that is heavier or lasts for more days than usual bleeding after menopause.
Many things can cause abnormal bleeding, including polyps endometrial atrophy endometrial hyperplasia endometrial cancer. The risk factors for endometrial cancer include getting older early age when periods started older age at menopause never having been pregnant irregular periods history of infertility long-term use of medications containing high doses of estrogen obesity polycystic ovary syndrome PCOS treatment with a drug called tamoxifen certain tumors of the ovaries history of diabetes mellitus , high blood pressure , gallbladder disease, or thyroid disease personal or family history of certain types of cancer such as ovarian cancer or colon cancer smoking Endometrial cancer also can occur without any of these risk factors.
Other causes of bleeding after menopause include hormone therapy infection of the uterus or cervix use of some medications other types of cancer. Polyps may be removed with a surgical procedure. Endometrial atrophy can be treated with medications. Cervix: The lower, narrow end of the uterus at the top of the vagina.
Chemotherapy: Treatment of cancer with drugs. Endometrium: The lining of the uterus. Estrogen: A female hormone produced in the ovaries. Hysterectomy: Surgery to remove the uterus. Ovulation: The time when an ovary releases an egg.
Perimenopause: The time period leading up to menopause. Radiation Therapy: Treatment with radiation. Article continues below Advertisement. If you have further questions, contact your ob-gyn. Don't have an ob-gyn? At the same time, they may take a tiny sample of your cervix for testing called a cervical screening test. The kind of treatment you have will depend on what is causing the bleeding. Atrophic vaginitis and thinning of the endometrium are usually treated with drugs that work like the hormone oestrogen.
These can come as a tablet, vaginal gel or creams, skin patches, or a soft flexible ring which is put inside your vagina and slowly releases the medication.
Polyps are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic. An ultrasound of your pelvis to get a picture of your cervix, uterus, endometrium and ovaries. An external ultrasound is a small hand held device called a transducer that the doctor will move over you belly. An internal ultrasound is a small wand that the doctor inserts into your vagina to get a better image of your cervix and uterus.
A pipelle test to take and test a sample or biopsy of your endometrium. This can be done without anaesthetic in a day clinic with a thin tube or pipelle which is put into your uterus through your vagina and gently sucks up a small sample of cells.
A hysteroscopy to take photos of your cervix, uterus and endometrium. A sample or biopsy of your endometrium may also be taken for testing. Although some women may abruptly stop having menstrual periods, many women will notice that their periods space out for months to years before bleeding stops permanently. Although pregnancy is unlikely in this age group, it is essential to do a pregnancy test to be absolutely sure.
Why is bleeding irregular in perimenopause? Regular periods are the result of a precise hormone balance causing regular ovulation. In perimenopause changes in hormone levels interfere with ovulation. If ovulation does not occur, the ovary will continue making estrogen, causing the endometrium to keep thickening. This often leads to a late menstrual period followed by irregular bleeding and spotting.
This can also result in endometrial polyps, a greater thickening called "hyperplasia," or in extreme long-standing cases, cancer of the lining of the uterus. How do I know if my bleeding is abnormal? It is not unusual to have irregular bleeding for up to 6 months before menstrual periods stop completely.
Unless the bleeding is excessive, or a woman it at high risk for uterine cancer, this is generally not of concern. I feel it is best to evaluate the cause of any irregular bleeding in high risk women. How is abnormal uterine bleeding in menopause or perimenopause evaluated? Traditionally, an endometrial biopsy, or sampling of the lining of the uterus is done. This is a simple office procedure to rule out cancer or pre-cancer. It is not accurate for diagnosing polyps or fibroids. Vaginal probe ultrasound is a quick and painless screening exam and has frequently made endometrial biopsy unnecessary.
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