What is Post menopausal Bleeding?
Post menopausal bleeding refers to any vaginal bleeding after the menopause. It should always be followed up, as it may be a sign of cancer.
Does this always mean cancer?
No in fact 80% of the time it is not cancer.
What are the causes of Post menopausal Bleeding?
Endometrial Polyps, very thin endometrial or vaginal lining (atrophy) because of low oestrogen levels, Cancers (vaginal, uterine, cervical, vulval). Bleeding from the bowel or bladder also needs to be considered.
How should this be investigated?
A full examination including vaginal examination is mandatory.
Any or all of the following may be used to exclude cancer and to make the diagnosis of where the problem lies:
- Ultrasound - this is a good starting point to assess is the endometrial (uterine) lining is thicker then it should be or not.
- PAP smear and or colposcopy (magnified view of the cervix and vagina) – if not up to date and anything suspicious.
- Pipelle biopsy – a very small, specialised device to take a sample of tissue from inside the uterus through the cervix.
- Dilation and Curette / Hysteroscopy - this is performed as a day surgical procedure under general anaesthetic and is usually required to exclude cancer pending other results and examination findings.
- The entire workup including ultrasound and pipelle can all be performed in rooms at Greenslopes Specialist Gynaecology and any necessary day surgery can be arranged with Dr Land at Greenslopes Private.