What are the symptoms of fibroids after menopause. How are postmenopausal fibroids treated. Can fibroids grow after menopause. What are the risks of fibroids in postmenopausal women. How does hormone therapy affect fibroids after menopause.

Understanding Fibroids in Postmenopausal Women

Uterine fibroids, also known as leiomyomas or myomata, are benign tumors that develop in the muscular wall of the uterus. While these growths are most common during a woman’s reproductive years, they can persist or even develop after menopause. However, the occurrence of new fibroids after menopause is relatively rare.

The prevalence of fibroids varies among different ethnic groups. By age 50, approximately 70% of white women and over 80% of Black American women are affected by fibroids. Black women of African origin face a significantly higher risk and tend to develop larger fibroids at an earlier age.

Fibroids and Estrogen: The Postmenopausal Connection

Fibroids are estrogen-dependent growths, meaning they require this hormone to develop and grow. After menopause, estrogen levels naturally decrease, which typically leads to a reduction in fibroid size and associated symptoms. However, this is not always the case, and some women may continue to experience fibroid-related issues even after menopause.

Symptoms of Postmenopausal Fibroids

The symptoms of fibroids in postmenopausal women can be similar to those experienced during the reproductive years. Common signs include:

• Abnormal uterine bleeding
• Enlarged abdomen
• Feeling of fullness in the lower abdomen
• Pain during sexual intercourse
• Pressure on the bladder or bowels
• Frequent urination
• Lower back pain

Are postmenopausal fibroids always symptomatic. No, the presence of symptoms can vary greatly among individuals. Some women may have multiple or large fibroids without experiencing any noticeable symptoms, while others might have severe discomfort even with smaller growths.

Diagnosis and Monitoring of Postmenopausal Fibroids

Diagnosing fibroids in postmenopausal women often involves a combination of physical examination, imaging tests, and sometimes biopsy. Regular monitoring is crucial, even if fibroids are asymptomatic, to track any changes in size or characteristics.

Importance of Medical Evaluation

While fibroids are typically benign, it’s essential to seek medical advice if you experience any symptoms associated with fibroids. In rare cases (fewer than 1 in 1,000), a growth that appears to be a fibroid may contain cancerous cells. Therefore, proper evaluation and monitoring are critical for ruling out more serious conditions.

Treatment Options for Postmenopausal Fibroids

The approach to treating fibroids in postmenopausal women depends on various factors, including the size and location of the fibroids, the severity of symptoms, and the patient’s overall health. Here are some common treatment options:

Watchful Waiting

For many postmenopausal women with asymptomatic or mildly symptomatic fibroids, a “watch and wait” approach may be recommended. This involves regular check-ups to monitor the fibroids’ size and any potential symptoms.

Medications

Several medications can help manage fibroid symptoms or reduce fibroid size:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief
• Gonadotropin-releasing hormone agonists (GnRHa) to shrink fibroids
• Hormonal treatments like birth control pills or intrauterine devices (IUDs)

Surgical Interventions

In cases where fibroids are large or causing severe symptoms, surgical options may be considered:

1. Myomectomy: Removal of fibroids while preserving the uterus
2. Hysterectomy: Complete removal of the uterus
3. Uterine Fibroid Embolization (UFE): Minimally invasive procedure to block blood supply to fibroids

Hormone Therapy and Its Impact on Postmenopausal Fibroids

Hormone therapy (HT) is often used to manage menopausal symptoms by maintaining estrogen and progesterone levels. However, this can have implications for women with fibroids. Does hormone therapy affect fibroid growth after menopause. Yes, as fibroids are estrogen-dependent, hormone therapy may potentially stimulate their growth or prevent their natural regression.

Women considering hormone therapy should discuss the potential risks and benefits with their healthcare provider, especially if they have a history of fibroids. In some cases, alternative treatments for menopausal symptoms may be recommended to avoid exacerbating fibroid-related issues.

Racial Disparities in Fibroid Prevalence and Treatment

Research has consistently shown that Black women are disproportionately affected by uterine fibroids. They are not only more likely to develop fibroids but also tend to experience more severe symptoms and complications. This disparity persists even after menopause.

Factors Contributing to Racial Disparities

Several factors may contribute to the higher prevalence and severity of fibroids among Black women:

• Genetic predisposition
• Hormonal differences
• Environmental factors
• Socioeconomic disparities affecting access to healthcare

How do these disparities impact treatment outcomes. The higher prevalence and severity of fibroids in Black women can lead to more aggressive treatments, including a higher rate of hysterectomies. This underscores the importance of culturally competent care and personalized treatment approaches.

Long-term Outlook and Quality of Life Considerations

While fibroids are benign tumors, they can significantly impact a woman’s quality of life, even after menopause. Chronic pain, heavy bleeding, and pressure symptoms can affect daily activities, work performance, and overall well-being.

Managing Fibroid-related Symptoms

For postmenopausal women dealing with persistent fibroid symptoms, a multifaceted approach to management may be beneficial:

• Regular exercise to help manage pain and improve overall health
• Dietary modifications to support hormonal balance
• Stress reduction techniques like meditation or yoga
• Pelvic floor physical therapy for related muscular issues

Can lifestyle changes help manage postmenopausal fibroids. While lifestyle modifications alone may not eliminate fibroids, they can play a crucial role in managing symptoms and improving overall quality of life. It’s important to work with healthcare providers to develop a comprehensive management plan tailored to individual needs.

Emerging Research and Future Directions

The field of fibroid research is continuously evolving, with new insights into the genetic and molecular basis of these tumors emerging. This research holds promise for developing more targeted and effective treatments for fibroids, including those that persist after menopause.

Potential Future Treatments

Some areas of ongoing research include:

• Gene therapy targeting fibroid-specific mutations
• Novel hormonal treatments with fewer side effects
• Improved minimally invasive surgical techniques
• Personalized medicine approaches based on genetic profiles

How might these advancements change the management of postmenopausal fibroids. As our understanding of fibroid biology improves, we may see more targeted therapies that can effectively shrink or eliminate fibroids without the need for invasive surgeries. This could significantly improve the quality of life for women dealing with persistent fibroids after menopause.

In conclusion, while fibroids typically shrink after menopause due to decreased estrogen levels, they can still cause issues for some women. Understanding the symptoms, treatment options, and potential complications of postmenopausal fibroids is crucial for effective management. Regular medical check-ups, open communication with healthcare providers, and staying informed about new developments in fibroid research can help women navigate this aspect of postmenopausal health effectively.

Fibroids after menopause: Symptoms, treatment, and outlook

Fibroids after menopause are not usually a cause for concern. Uterine fibroids are benign or noncancerous tumors or growths that develop in the muscular wall of the uterus. They develop when estrogen is present and usually shrink after menopause.

Fibroids — also called leiomyomas or myomata — can be present both before and after menopause. They are common and can appear at any age but are more likely to appear in the more advanced reproductive years as menopause approaches. It is rare for fibroids to appear after menopause.

At the age of 50, fibroids affect around 70% of white and over 80% of Black American females. The risk is significantly higher among Black American females of African origin. Black females are also more likely to have larger fibroids and to develop them from an earlier age.

Fibroids vary in size and number. Before menopause, they can affect fertility. After menopause, they tend to shrink in size due to lower estrogen levels. However, they can still be an issue, leading to pain and unusual bleeding.

Fibroids are noncancerous, but they can resemble cancerous tumors. For this reason, a doctor may remove them or take a biopsy to rule out cancer.

How do fibroids affect Black women?

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Fibroids need the hormone estrogen to grow. After menopause, estrogen levels decrease dramatically, which usually reduces the risk of developing fibroids.

In many cases, fibroids shrink and cause fewer symptoms after menopause.

However, some people may not see a decrease in symptoms.

Hormone therapy (HT) aims to maintain levels of estrogen and progesterone during perimenopause and after menopause. For this reason, fibroids may continue to grow.

Some treatments for fibroids mean a person can no longer become pregnant. Often, this is not an issue after menopause. However, it may be a consideration for anyone who has passed menopause and is considering pregnancy through assisted reproductive technologies.

According to the Office on Women’s Health, fibroids can vary from the size of an apple seed to that of a grapefruit. A person can have one or many. For this reason, some people have no symptoms, while others can experience severe discomfort.

The symptoms of fibroids often remain the same regardless of a person’s age.

They can include:

• heavy bleeding during the reproductive years and bleeding that can continue after menopause
• enlarged abdomen
• a feeling of fullness in the lower abdomen
• pain during sex
• pressure on the bladder or bowels
• frequent urination
• lower back pain

Fibroids are benign by definition, but in rare cases, a growth that appears to be a fibroid contains cancerous cells. This happens in fewer than 1 in 1,000 fibroids. Moreover, the pain and discomfort of fibroids can severely affect a person’s overall well-being and quality of life, including their ability to work or perform routine activities.

For these reasons, a person should seek medical advice if they have any symptoms of fibroids.

Treatments for fibroids can range from a “watch and wait” approach if there are no symptoms to a myomectomy if symptoms are severe.

Factors a doctor will consider when deciding on a treatment plan include:

• size of the fibroids
• location of the fibroids
• a person’s age
• the presence and severity of symptoms

Before menopause, fibroids can affect fertility. After menopause, most people do not need treatment for fibroids unless the fibroids are large or they have severe symptoms.

Here are some options a doctor may recommend.

Watch and wait

Many people choose not to have treatment for their fibroids because they tend to shrink or go away after menopause.

However, it is still important to check in with a doctor regularly to check if they have grown.

Medication

If the fibroids are causing symptoms, doctors may recommend medications.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or acetaminophen, may help relieve pain.

Gonadotropin-releasing hormone agonists (GnRHa), such as Lupron, can help shrink fibroids and make them easier to remove during surgery. A person can take GnRHa drugs by injection, nasal spray, or as an implant.

Other options include oral birth control pills or having an intrauterine device (IUD).

Surgery

Surgery may be an option if fibroids are large, or symptoms are severe.

Myomectomy

This procedure removes fibroids but leaves the healthy tissue of the uterus. New fibroids can develop after a myomectomy. Pregnancy may still be possible after this surgery.

Surgery can be open or hysteroscopic, depending on the extent of the fibroids. In a hysteroscopy, a surgeon inserts a long, thin device through the vagina and cervix into the uterus. A camera on the end of the device enables the surgeon to see the inside of the uterus. During this procedure, the surgeon can use the same tool to remove fibroids.

Hysterectomy

A hysterectomy is a procedure to remove the uterus. If surgery happens around menopause, the surgeon may also remove the ovaries.

A hysterectomy will end the symptoms of uterine fibroids, making it a suitable choice for someone with severe symptoms who is not planning to have children.

Surgeons perform a hysterectomy using open or laparoscopic surgery. They may also use a vaginal approach in a procedure known as a laparoscopic-assisted vaginal hysterectomy.

Depending on the type of surgery, recovery can take up to 6 weeks.

In the United States, fibroids are the most common reason for a hysterectomy, accounting for 37% of hysterectomies each year.

Endometrial ablation

In endometrial ablation, a surgeon removes or destroys the lining of the uterus. This can help manage symptoms.

It is possible to become pregnant after this procedure, but doctors do not advise it due to the risk of pregnancy loss and other issues. People should only undergo ablation if they are no longer planning to have children.

Myolysis

In myolysis, a doctor inserts a needle into a fibroid and passes either an electric current or freezing mechanism through the needle to destroy the fibroid tissue. It is also known as radiofrequency ablation.

Uterine fibroid or artery embolization

Uterine fibroid embolization — also called uterine artery embolization — involves blocking the blood vessels that bring blood to the fibroid. The fibroid should shrink, but pregnancy may not be advisable in the future.

People should speak with a doctor about the advantages and disadvantages of each treatment before deciding to go ahead.

Why do Black women not get the same gynecological care as others?

Fibroids are not cancerous, and most will shrink after menopause. At the same time, symptoms will likely improve.

However, fibroids may persist in those using hormone treatment. Various approaches can help resolve this, depending on whether a person still hopes to become pregnant, for example, through assisted reproductive technology.

Here are some questions people often ask about fibroids during menopause.

Should I worry about uterine fibroids after menopause?

After menopause, fibroids usually shrink, and symptoms improve. However, a person should seek medical advice if they have bothersome or ongoing symptoms or if they notice any bleeding after menopause. These may be signs of another health issue, such as cancer.

What are the symptoms of uterine fibroids after menopause?

Many people have no symptoms, and symptoms often improve after menopause, but it is still possible to experience:

• lower abdominal pain and swelling
• lower back pain
• vaginal bleeding or spotting
• frequent urination
• a feeling of pressure in the pelvis

Can fibroids still grow after menopause?

It is rare because estrogen levels are usually very low at this stage, but it can happen. Anyone with concerns about fibroids or symptoms affecting their lower abdomen should seek medical advice. A doctor may wish to rule out other conditions, such as uterine cancer.

Uterine fibroids are noncancerous growths that commonly appear in females of reproductive age, particularly as they get older toward menopause. However, estrogen levels fall with menopause, and there is a lower risk of fibroids with symptoms.

Anyone experiencing vaginal bleeding, discomfort, or other symptoms after menopause should seek medical advice, as the symptoms of fibroids can resemble those of some severe conditions, such as cancer.

time to talk with the doc

One of the problems Gennev is out to solve is the lack of information many women run up against when they try to research some strange new thing their body is doing. (Cold flashes in menopause? Who knew those even existed?!)

One concern we hear about from women is bleeding months or even years after a woman is in full menopause. Bleeding after menopause, like many things in midlife bodies, is probably not caused by anything dangerous. However, any bleeding after menopause isn’t normal and can signal something more serious.

We talked to Dr. Jessie Marrs of the Swedish Cancer Institute. Board-certified in obstetrics and gynecology with a special interest in women in menopause, Dr. Jessie was able to give us some very comprehensive answers to some very important questions.

What is post-menopausal bleeding?

Dr. Jessie: First, let’s start with a definition so we all know we are on the same page. When someone goes through menopause, it essentially means their menses have stopped.

Women are considered “menopausal” when they have had no period for an entire year. This definition is important because it also helps us define post-menopausal bleeding which can have some important implications.

Why does post-menopausal bleeding happen?

Dr. Jessie: Post-menopausal bleeding (PMB) can happen for a variety of reasons. Sometimes it is from tearing of the vaginal tissues after intercourse. It can happen because of polyps or fibroids in the cervix or uterus.

Some women will develop such a thin lining of the uterus after menopause that they can bleed a little bit. Medications, such as hormone replacement therapy, anticoagulants or tamoxifen can also cause bleeding after menopause.

Occasionally it is related to pre-cancer or cancer of the lining of the uterus.  This is obviously the thing we worry most about. The good news is, cancer of the uterine lining (endometrial cancer) generally presents early with vaginal bleeding and is often curable. This is why it is important to see your doctor if you have any bleeding after menopause.

If you are bleeding after menopause, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.

What is the most common cause of bleeding after menopause?

Dr. Jessie: About 40 percent of bleeding after menopause is caused by non-cancerous polyps in the lining of the uterus. The second most common cause is vaginal atrophy or thinning of the uterine lining. 

How can I distinguish more serious issues from spotting after menopause for other reasons (post-coital tearing, etc.)? Are there other warning signs?

Dr. Jessie: It can be very challenging to distinguish pre-cancer or cancer of the uterus from other causes without an exam. Things like weight loss, pain or persistent bleeding are more likely with advanced cancers.

Bleeding without any other symptoms can be a sign of early cancer. Because of this, I don’t recommend trying to decide for yourself where your bleeding is coming from. It is always worth seeing your doctor for this issue.

Can fibroids cause bleeding after menopause?

Dr. Jessie: Yes, although this is unusual. Most fibroids shrink after menopause and become less symptomatic than they were prior to menopause.

Fibroids that are pushing in to the cavity of the uterus can certainly cause post-menopausal bleeding, but I usually see this in patients who are in their early 50s; they think they are not menopausal because they continue to bleed, but the bleeding is actually coming from the fibroid and not a hormonal cycle.

I don’t usually see bleeding from fibroids starting up when a woman is already well in to menopause. If you know you have fibroids and are having bleeding after menopause, I would definitely recommend a visit to your doctor rather than writing the symptoms off as coming from the fibroids. Very rarely, women can develop a fibroid-related uterine cancer called a sarcoma.

Is any post-menopausal discharge normal?

Dr. Jessie: Most women develop some level of vaginal dryness after menopause. This is related to the decreasing hormonal effect of estrogen can create vaginal issues and changes and effect tissues.  Some discharge can still be normal, particularly if it is white, clear or creamy in texture. Copious amounts of watery discharge, bloody, or even brown- or pink-tinged discharge would be considered abnormal.

Does it matter how far after menopause you are? Say, six months post-meno as opposed to six years?

Dr. Jessie: It doesn’t. Post-menopausal bleeding can be an indicator for abnormal cells in the uterine lining at any point after menopause. While there are probably more benign conditions that can cause some vaginal bleeding the closer you are to menopause (including a late burst of hormone from the ovaries), if you have gone a full year without a period, you need to get in to see your doctor.

I have spotting after menopause on my underwear; what do I do?

Dr. Jessie: Please call your doctor and make an appointment. As long as the bleeding is minimal, this is not an emergency, but I like to get patients in for this problem within the next week. While seeing your gynecologist is generally not as fun as, say, buying some new shoes (yes, that is my weakness), the work up for post-menopausal bleeding is pretty straight forward and can bring some peace of mind.

Does it matter if it’s heavy or light? Is just a little spotting OK?

Dr. Jessie: Great question, I frequently have patients delay seeing me for bleeding after menopause because it was a small amount. Even the smallest amount of vaginal bleeding after menopause is considered abnormal and deserves a work up.

What will the doctor do if I tell her I have post-menopausal bleeding?

Dr. Jessie: When you come in to the office for bleeding after menopause, your doctor will take a thorough history to get a better idea where the bleeding might be coming from. She will do a physical exam and inspect the vulva, vagina and cervix to look for a potential source of the bleeding. She’ll also do a pelvic exam to see if the uterus feels enlarged or the ovaries feel abnormal.

Because PMB is a warning sign for pre-cancer or cancer of the lining of the uterus, even if she finds a likely cause during the exam, your doctor will do some sort of an evaluation of the lining of the uterus. This may be an ultrasound to determine the thickness of the lining or it may be a biopsy of the lining of the uterus.

Can I wait and see if it happens again before going to my doc?

Dr. Jessie: Please don’t wait! It is very likely that your bleeding is nothing to worry about and just a nuisance, but occasionally it can be a sign of something more serious. It is always worth a check-up!

If you’re experiencing post-menopausal bleeding, please follow Dr. Jessie’s advice and schedule an appointment right away. If you don’t have an ob/gyn, you book a virtual appointment at Gennev Telehealth. If you’ve dealt with PMB, what caused it and how did you deal with it? Please share with the community: leave us a comment below, or talk to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

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June 25, 2018

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Bleeding with uterine fibroids, uterine bleeding

Myoma is a benign neoplasm that occurs in many women. But in most cases, there are no symptoms, and the woman does not even know that there are myomatous nodes in her uterus. The diagnosis is established by chance, for example, during an ultrasound examination of the pelvic organs or the abdominal cavity.

In general, fibroids are not dangerous. These are benign formations, they never transform into cancer. But they can cause quite unpleasant symptoms. One of the most common is uterine bleeding.

Long periods for uterine fibroids

Women normally have a monthly cycle of 25–31 days. Menses last from 3 to 7 days. During this time, a woman on average loses 50 ml of blood, about 2-3 tablespoons. Maximum – 80 ml.

The phrase “uterine bleeding” can refer to different conditions, each of which has its own medical term:

• Menorrhagia – long, heavy periods that last more than a week, and during which a woman loses more than 80 ml of blood. They occur regularly, at approximately the same time intervals, like regular periods.
• Metrorrhagia – irregular bleeding that occurs between periods.
• Polymenorrhea – periods that recur more than 21 days later.
• Menometrorrhagia – frequent, profuse and irregular bleeding.
• Dysmenorrhea – painful periods.

Irregular, painful, profuse and prolonged periods are most characteristic of uterine fibroids. These symptoms are most pronounced in reproductive age. During menopause, they usually disappear (but not for everyone), as the level of hormones in the body drops, and the fibroids shrink in size.

As a rule, submucosal nodes that are located under the mucous membrane in the uterine cavity lead to heavy menstruation and bleeding in fibroids.

They prevent the mucosa from contracting, which makes bleeding longer and more profuse. It is they who are most often manifested by vivid symptoms, while nodes of other localizations (in the thickness of the uterine wall, outside) are often “silent”. Significant symptoms can be caused by a submucosal nodule as small as 1–3 cm in diameter.

What symptoms may occur?

You need to see a gynecologist if you have the following symptoms:

• You notice that your periods are heavier than before. A woman may notice that she began to spend more hygiene products, she has to choose more “drops”.
• During menstruation, you feel worse, soreness occurs. Worried about weakness, increased fatigue.
• The duration of menstruation has increased.
• There is pressure, discomfort, pain in the pelvis.
• Enlargement of the abdomen, something solid can be felt in it. If the fibroid is large enough, it protrudes, is noticeable when the woman lies on her back.
• Disturbed by pain in the pelvis, legs.
• Urination has become frequent or difficult.
• Constant constipation.
• Your vagina bleeds when you don’t have your period.

These signs may indicate not only myoma, they are found in various diseases. An accurate diagnosis will be established by a gynecologist after examination and ultrasound.

Anemia due to fibroids

Continuous blood loss due to fibroids can lead to anemia. The level of erythrocytes and hemoglobin in the blood decreases. The woman constantly feels tired, becomes pale, suffers from headaches and dizziness. Sometimes the appetite is perverted and drawn to inedible things – for example, you may want to gnaw on a piece of chalk. Hair loss and brittle nails are also possible symptoms of anemia.

The brain of an anemic woman is constantly in conditions of oxygen starvation. There is “fog” in the head, the quality of life is reduced. Appearance deteriorates. And all this is due to fibroids.

How to reduce and stop bleeding in uterine fibroids?

To stop bleeding and normalize periods, you need to remove the cause of the problem. Everything else, including taking iron supplements and painkillers, are only temporary half-measures. Myoma, which is accompanied by symptoms, is a direct indication for treatment.

Previously, by and large, only two operations were available – removal of fibroids (myomectomy) or the entire uterus (hysterectomy). No uterus – no bleeding – no problem. Unless, of course, we take into account the risks that are present during any operation, the relatively high probability of recurrence in the next two years and complications after the removal of one of the main organs of the female reproductive system.

Currently, there is a minimally invasive intervention – uterine artery embolization, abbreviated UAE. During the procedure, the doctor makes a puncture in the upper part of the thigh, inserts a special catheter through it into the uterine artery, and injects an embolizing drug. The latter consists of microspheres that block the blood flow of the myomatous node, the myoma is deprived of oxygen and “dries out” – it is replaced by connective tissue. Fast, safer than myomectomy, no anesthesia (but not painful – local anesthesia is performed at the puncture site), and the efficiency reaches 98%.

Now the UAE method is already well studied and used in clinics in Europe as a routine procedure. This type of treatment is also available in Russia.

Many women, having got rid of fibroids, are surprised to find that life without constant fatigue, headaches and “fog” in the head is completely different. Before and after are two completely different states. Contact us to learn more about uterine artery embolization and to book an appointment.

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Uterine bleeding during menopause: causes and treatment

Every woman after a certain age faces a natural and irreversible process – menopause. But this new period of life is sometimes overshadowed by the complications of menopause: pain, increased sweating and nervousness, weight gain, depression and bleeding. Why do such problems arise and, most importantly, how to treat them, how to deal with them? Let’s figure it out.

Bleeding during menopause: what is it?

During menopause, women often experience spotting, which can vary in intensity, abundance, pain and consequences. Bleeding during this period is any spotting that should alert the patient. They are not normal and require medical advice. For many women, the period of menopause is the time when they forget about themselves, intimate life, visiting the gynecologist. And the appearance of such secretions is a “bell” that should encourage the fair sex to take care of their health.

Menopause has 3 stages: premenopause (menstruation can still sometimes “occur”), menopause itself (when the last “critical days” go) and postmenopause (the period that occurs after the last menstruation). In all these stages, the appearance of spotting is quite possible. But bleeding in menopause, the treatment should be adequate, clearly selected by the doctor. You don’t have to deal with this problem on your own. Even if the bleeding was one-time, you still need to be examined.

Classification of bleeding during menopause

Bleeding during menopause is different and can be divided into types. They are:

• Organic. Such spotting associated with diseases of the kidneys, liver, reproductive and circulatory systems.
• Iatrogenic . Such bleeding occurs due to the fact that the patient is taking some drugs.
• Uterine bleeding according to dysfunctional type . They are connected with the fact that there is an imbalance in the work of the reproductive system, problems with hormones.

You can also distinguish such uterine bleeding during menopause:

• Menorrhagia – such bleeding is characterized by a duration of more than 7 days and a large amount of discharge. Bloody discharge occurs according to a specific cycle. The woman already knows when to expect them.
• Metrorrhagia. Bleeding of this type is characterized by a small volume of blood, but occurs spontaneously.
• Menometrorrhagia . Such secretions appear without cyclicity, at any time, but they have a large volume of secretions.
• Polymenorrhea . These are discharges that cannot be considered menstruation, but at the same time appear with a certain cyclicity. Usually their interval is 21 days, but no more.

In any case, the treatment of bleeding during menopause should be prescribed exclusively by a doctor after a thorough examination. No matter what type of spotting is present, this condition cannot go unnoticed.

Why menopausal bleeding occurs

There can be many reasons for bleeding during menopause. Some of them are quite harmless, but there are those that indicate a serious illness. As a rule, a woman herself cannot figure this out, since this requires a detailed consultation with a doctor. But the treatment of uterine bleeding with menopause is required almost constantly, and how it will go depends on the causes.

Causes of bleeding during menopause can be:

• Hormonal disorders.
• Certain medications, including hormones and birth control.
• Early onset of menstruation, absence of labor or a large difference between them, refusal to breastfeed.
• Heredity.
• Uterine fibroids.
• Uterine cancer.
• Ovarian dysfunction.
• Endometriosis.
• Endometrial hyperplasia.
• Polyps present on the endometrium.
• Vaginitis
• Tumors, ovarian cysts.
• Ovarian cancer.
• Cervical cancer.

What are the symptoms of bleeding?

Treatment of menopausal bleeding is a process that requires a careful study of the symptoms of the disease. The main sign of pathology is the presence of bloody discharge. They can be very abundant, and sometimes quite scarce, often such bleeding resembles a “daub”, the discharge of blood in which is insignificant. Sometimes they contain mucus. The color can also be different: from bright scarlet to dark brown. But regardless of this, even a small amount of blood should be considered bleeding. It also happens that the blood changes its color from red to black. All these symptoms are extremely dangerous and can indicate the presence of infections, tumors and various problems.

Especially dangerous symptoms of bleeding are fever, dizziness, pale skin, cold sweat, prolonged discharge, sharp pain in the lower abdomen, a feeling of heaviness and “fullness” of the space in the lower abdomen. The most terrible and most dangerous symptom is a sharp profuse bleeding, in which the blood is bright scarlet, not thick, but rather liquid. In this case, the bleeding does not stop and increases, and there is a sharp, throbbing pain in the abdomen. Such conditions require urgent hospitalization and may even lead to the death of the patient.

How to diagnose a pathology?

Menopausal bleeding requires careful diagnosis using the most modern methods. Only they can accurately establish the diagnosis, the cause, and only then can treatment be prescribed. First of all, a detailed medical history will be required, in which the doctor will find out the symptoms, the history of the onset of menstruation, childbirth, abortion, surgery and other manipulations. Also, the doctor can ask about breastfeeding, the presence of gynecological diseases in close relatives. A thorough gynecological examination is mandatory, in which swabs are taken from the vagina. Based on primary examinations, the following diagnostic procedures can be prescribed:

• Testing for a hormonal panel, blood tests, blood clotting.
• Additional studies of the liver, kidneys, thyroid gland.
• Testing for tumor markers, liver tests.
• Vaginal or transvaginal ultrasound is performed.
• A biopsy is done, a study of biological material is carried out to detect oncological diseases.
• MRI of the pelvic organs underway

Depending on the results of the examination, additional examination procedures may be prescribed. Sometimes the diagnosis of uterine bleeding requires consultation not only of a gynecologist, but also of an endocrinologist, mammologist, oncologist, therapist, hematologist. If a woman has a number of concomitant diseases, then such a problem must be solved comprehensively, using all available specialists.

How to stop bleeding during menopause?

Treatment of uterine bleeding in menopause depends on the cause. Abnormal uterine bleeding during menopause can be one that requires immediate intervention, and sometimes one that requires inpatient or outpatient treatment with conservative methods. If bleeding is profuse, abdominal pain is severe, and the woman feels extremely unwell, an ambulance should be called. Next, you need to lie down, put something cold on your stomach. You should not take any medication yourself or try to use folk methods to stop bleeding.

If abnormal uterine bleeding during menopause is systematic, but does not pose a clear immediate threat to the patient’s life, they require treatment. It can be conservative or surgical. Everything depends on the reasons. If the problem is in the hormonal background, drug treatment is used to stabilize. If the cause is uterine fibroids, then a resection of this organ can be performed. This means that the uterus will be removed. Sometimes an ultrasonic ablation method is used, in which the fibroid is removed from the uterus. Sometimes uterine artery embolization is used. In this case, the tumor loses its blood supply and disappears.

Hyperplasia is treated with laser radiation, liquid nitrogen, electric current. With endometriosis, polyps, curettage is often used, which stops bleeding and allows you to take material for research.

If adenomyosis occurs, then resection of the damaged areas or uterus is performed.

If there are malignant tumors, then they are removed, as a rule, along with the organs on which they originated.

Complications of bleeding: what are they?

Heavy bleeding during menopause can have various complications. Do not take them as something insignificant and frivolous. Women during menopause often do not want to see a gynecologist and get treated. They believe that if menstruation stops, then their life and youth are over. But this is not so: even at this time, you can live an active sex life, enjoy and be happy. Therefore, you need to undergo a gynecological examination twice a year. After all, bleeding can have consequences:

• They are life-threatening if they occur suddenly, are very abundant, and can lead to large blood loss.
• May be a sign of malignant tumors, because if there is prolonged bleeding, without clarified reasons, then it may be cancer. And the sooner it is detected, the easier it is to treat. Otherwise, a woman may miss precious time and the opportunity to recover.
• If there are benign tumors (fibroids, cysts), no one can rule out that they will not develop into malignant ones. They need to be removed.
• Hormonal disorders and constant bleeding will lead a woman to a state of constant stress, nervousness, inability to have a sexual life.