Bleeding after menopause and postmenopause

After menopause, in most cases the occurrence of pathology is uterine bleeding. To understand the reason for this, it is necessary to know what is meant by the concept of "menopause" and "postmenopausal".

introduction

Menopause means by a recent independent menstruation. Formulation of this diagnosis is performed retrospectively with patient words. Modern diagnostic methods allow to diagnose menopause laboratory methods. This is indicated by: reducing estradiol levels below 30 pg / ml, to increase FSH 40 IU / L or more, and the absence of menstruation.

Postmenopause - the period of life of women after menopause. On it you can talk to the absence of menstrual function over 1 year.

During these periods, signs of bleeding from the genital tract should happen cause for immediate treatment for medical assistance.

Climax and absence of menstruation

The onset of menopause is an inevitable event. Usually, it is surrounded by a mass of "scary" stories about how to change for the worse existence of women. In reality, the severity of menopausal symptoms in the majority of the fair sex does not cause gross violations of quality of life. Mood swings, disorders of the autonomic nervous system effectively cropped by a special treatment. The absence of menstrual bleeding after menopause is a normal phenomenon.

the occurrence of bleeding

Often in postmenopausal women may experience symptoms of uterine bleeding. The reasons for this can be set. Given the trend to an increase in cancer in the population, oncological alertness should be mandatory.

The only reason that the post-menopausal bleeding from the genital tract can be the norm - receiving hormone replacement therapy, progesterone preparations. In this case, the post-menopausal woman notes the scant menstrual flow. These symptoms are observed every month for 1-2 years.

In other cases uterine bleeding in postmenopausal women of any intensity are an occasion consult a doctor immediately. Their appearance can be formidable developing a symptom of serious illnesses.

In premenopausal

Prior to the onset of menopause is a frequent occurrence of menopausal bleeding. Their appearance is the result of reducing the production of female sex hormones, as a result of which violated the cyclic changes in the endometrium.

Menopausal bleeding may begin in the next day of menstruation or after a delay. In some cases, they start coming earlier than expected.

From normal menstrual bleeding menopausal distinguish the following symptoms:

• Different intensity (discharge may be very scarce, smearing or, conversely, expressed);
• length (characteristic length of a regular bleeding from several weeks to several months);
• availability of relapse (sometimes menopausal bleeding occur within 3-5 years).

This phenomenon is typical for women with concomitant diseases of the endocrine system and metabolic disorders.

In postmenopausal

Occurrence postmenopausal uterine bleeding is a cause for further investigation.

In some cases, the woman ignoring emerged bleeding can cause danger to life.

Causes

The causes of uterine bleeding after menopause is a lot of pathological conditions, the treatment of any of which should be administered under medical supervision.

Myoma

Uterine bleeding uterine fibroids is one of the possible complications. Most often it occurs in women with benign tumor localization in the submucosa or intramuscular space. The presence of this disease in postmenopausal women indicates a high risk of malignant degeneration of fibroids.

polyps

The exact causes of endometrial polyps were found in postmenopausal women. The occurrence of bleeding in this pathology - a reason for immediate conduct additional diagnostics. There is a high risk of malignancy polyp.

hyperplasia

Hormonal disorders observed after menopause can cause proliferation of the mucosal layer in the uterine wall thickness. Common manifestation of this pathological condition are uterine bleeding. Treatment of endometrial hyperplasia can be done in two ways.

1. With the use of drugs.
2. Surgically.

adenomyosis

This pathology is one of the types of endometrial hyperplasia. Thus there is proliferation and its introduction into the muscle layer of the uterine wall. Parallel to this cyst may be formed in the myometrium. The cause of adenomyosis believe hormonal disorders that occur after menopause.

ovarian dysfunction

Upset production of sex hormones in postmenopausal women is the cause of acyclic bleeding of varying intensity.

Cancer

In postmenopausal women, the risk of detection of cancer increases by several times. Most experts see the reason for this decrease in the production of sex hormones. Diagnosed at an early stage malignant neoplasm of the uterus in most cases respond well to treatment. When the bleeding after menopause, the main task of diagnostic measures is to eliminate the cancer.

Early diagnosis - the key to successful treatment. Since this pathology for a long time can proceed virtually without symptoms, every woman in menopause should be extremely careful about their health. Careful monitoring of discharge from the genital tract allows time to identify the disease.

evidence

After menopause miss uterine bleeding difficult. On the background of prolonged absence of menstruation genital tract appear spotting. Their intensity can be varied. In postmenopausal bleeding may be accompanied by the following features:

• the appearance of pain in the lower abdomen or in the lumbar region. The pain may be of pulling, aching or cramping in nature;
• Bleeding is often the cause of iron deficiency anemia, symptoms of which are: the general deterioration health, weakness, lethargy, decreased performance and appetite, brittle hair and nails, pallor sheets;
• in some cases there may be an increase in the volume of the abdomen.

survey

Every woman with uterine bleeding after menopause is necessary to conduct a thorough diagnostic search. It must be remembered, the reason will be revealed soon, the more favorable the prognosis may be subsequent.

If metrorrhagia is pronounced, in parallel with the examination begin treatment.

Diagnostic minimum should include:

1. Medical history and pelvic examination.
2. Smear on onkotsitologiyu from the cervical canal.
3. Clinical blood test. Reveals signs of iron deficiency anemia, which developed against the background of metrorrhagia.
4. Coagulation.
5. Blood chemistry.
6. A blood test to determine the level of hormones: estrogens, progesterone, luteinizing hormone, follicle stimulating hormone, 17-ketosteroids.
7. Pelvic ultrasound.
8. If signs of free liquid being in the pelvic cavity must be adjustable holding puncture vaginal vault cytology resulting material. Diagnostically significant indication of malignancy is a significant increase in tumor markers titles in dynamics.
9. Blood tests for tumor markers: CA 125 and CA 199. In postmenopausal women, it is recommended to pass the study year.
10. Therapeutic and diagnostic scraping the uterine cavity and the cervix.
11. Hysterosalpingography.
12. Hysteroscopy.
13. MRI of the pelvic organs.

After menopause, the amount of diagnostic test depends on the individual woman, medical history and pelvic exam results.

Treatment

Hemostatic - the basis of the treatment of metrorrhagia. This type of treatment is called symptomatic. Drugs to stop the bleeding before the prescribed to establish the cause of bleeding.

Basic drugs used for relief metrorrhagia:

• Aminocaproic acid: action develops due to inhibition of fibrinolysis processes;
• Dicynonum (Etamsylate) reduces the permeability of blood vessel walls, thromboplastin activates synthesis. This drug is mainly assigned with uterine bleeding in postmenopausal women. In intramuscular effect develops after 1,5-2 hours after intravenous - 15-20 minutes.
• Calcium gluconate: strengthens vascular walls, reduces their permeability to blood cells;
• Vikasol: it stimulates the synthesis of prothrombin and prokonvertina.
• Oxytocin: hormonal drug having uterotonic action. Its effectiveness is due to mechanical compression of blood vessels while reducing the uterine walls.

Reducing the level of hormones in menopause can cause metrorrhagia. Hormone replacement therapy can be administered to correct estrogen deficiency. With this type of treatment is necessary to strictly follow the dosing regime as an abrupt drop hormone levels can cause a new episode of bleeding.

After establishing the final diagnosis by the attending physician, decide to surgical treatment. Possible to carry out the following manipulations:

• scraping the uterine cavity;
• polypectomy;
• myomectomy;
• hysterectomy;
• total hysterectomy with appendages.

In the case of cancer, in addition appointed laser and chemotherapy.

Actions at home

If signs of metrorrhagia postmenopausal woman should evaluate its intensity. Spotting from the genital tract should be a reason for the planned visit to a doctor. At home, the following actions should be taken on their own:

1. Cold on lower abdomen. Exposure time should be 15 minutes. After a five-minute rest, you must repeat the procedure. The total duration of the cold use should be 2-2.5 hours.
2. Women in the horizontal position, the pelvis is enclosed by a special pillow or cushion. The purpose of this manipulation - providing the blood outflow from the pelvic organs, improving its circulation in vital organs.
3. Restoration of fluid balance in the body. It is necessary to drink plenty of liquids: clean water, tea, broth hips.
4. Special hemostatic agents is recommended after consultation with a specialist.
5. Admission bath or a hot shower, douching, heat pelvic use is strictly prohibited. These procedures cause dilation of blood vessels, which may lead to increased bleeding.

When signs metrorrhagia high intensity need urgent hospitalization.