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Some of the common causes of menopausal bleeding are listed below. Cancer is a much rarer cause of post menopausal bleeding.
Polyps are usually noncancerous growths that develop from tissue similar to the endometrium, the tissue that lines the inside of the uterus. They either attach to the uterine wall or develop on the endometrial surface. They may cause irregular or heavy bleeding. Polyps also can grow on the cervix or inside the cervical canal. These polyps may cause bleeding after sex.
After menopause,the endometrium may become too thin as a result of low oestrogen levels. This condition is called endometrial atrophy. As the lining thins, you may have abnormal bleeding.
In this condition, the lining of the uterus thickens. It can cause irregular or heavy bleeding. Endometrial hyperplasia most often is caused by excess estrogen without enough progesterone. In some cases, the cells of the lining become abnormal. This condition, called atypical hyperplasia, can lead to cancer of the uterus. When endometrial hyperplasia is diagnosed and treated early, endometrial cancer often can be prevented.
Bleeding is the most common sign of endometrial cancer in women after menopause.
You will need a physical exam. You also may have one or more of the following tests:
Endometrial biopsy - Using a thin tube, a small amount of tissue is taken from the lining of the uterus. The sample is sent to a lab where it is looked at under a microscope.
Transvaginal ultrasound - Sound waves are used to create a picture of the pelvic organs with a device placed in the vagina.
Sonohysterography - Fluid is injected into the uterus through a tube, called a catheter, while ultrasound images are made of the uterus.
Hysteroscopy - A thin, lighted tube with a camera at the end, called a hysteroscope, is inserted through the vagina and the opening of the cervix. The hysteroscope allows the inside of the uterus to be seen.
Dilation and curettage - The opening of the cervix is enlarged. Tissue is scraped or suctioned from the lining of the uterus. The tissue is sent to a lab, where it is examined under a microscope.
Treatment options are extensive due to the wide range of causes of menopausal bleeding. Miss Wilson will explain them once a diagnosis has been made.