Episodes of bleeding after the onset of menopause, otherwise known as post menopausal bleeding (PMB), are not unusual, nor are they signs of serious problems necessarily. Changes that occur in a woman's body at this time can present symptoms that result in minor temporary bleeding from the vagina and most often are related to the endometrial lining of the uterus. Only about 20% of women who experience PMB have symptoms of more serious problems.
Causes of PMB
According to J. Glenn Bradley, MD in most cases, vaginal bleeding is caused by hormone replacement therapies, which are commonly prescribed for post menopausal women due to changes in hormone production that occur as a result of menopause. Hormone imbalances, especially between levels of estrogen and progesterone, affect the uterine lining (endometrium), which can become sensitive and irritated by imbalances, resulting in occasional bleeding. A lack of sufficient estrogen that causes atrophy of the uterine lining will result in blood vessels becoming fragile and bleeding.
Other Causes of PMB
Unusual growths in the uterus, such as polyps and fibroids, can also cause vaginal bleeding. According to the American College of Obstetricians and Gynecologists polyps are the more common of these two growths and normally will only result in spotting or light, intermittent bleeding. Fibroid growth, however, will cause heavier vaginal bleeding due to their affect on the uterine lining. Endometrial hyperplasia, an overgrowth of the uterine lining, will cause heavier bleeding and can result in cancerous cell growth if left untreated.
Vaginal Dryness Associated with Menopause
The changes that take place during post menopause may also lead to a drying out of the lining of the vagina. Hormonal imbalances, especially related to a lack of estrogen, can cause the mucosal lining of the vagina to become thin, dry and less flexible. According to Abimbola Famuyide M.B.B.S tissue within the vagina will then become more vulnerable to inflammation and breakdown, often leading to episodes of bleeding. Sexual intercourse or a pelvic exam may also lead to vaginal bleeding associated with menopausal changes.
Diagnosis of PMB and Vaginal Dryness
Concerns about PMB can be addressed by tracking cycles of spotting, staining, or bleeding episodes. Information as to when bleeding occurs, how long it lasts and the frequency of bleeding will be helpful in clinical diagnosis, as well as any steroids or hormones that are taken. A doctor may perform a pelvic exam and a PAP test, as well as look for indications of polyp growth or signs of vaginal atrophy that may be causing bleeding.
Further Examination
Follow-up examinations may be needed if more serious symptoms of bleeding are present. A biopsy of the uterine lining and possibly the cervix will be done in an outpatient procedure. A dilation and curettage (D and C) procedure may be prescribed to examine more thoroughly the condition of the uterus and the endometrium. If these tests do not readily indicate the cause of bleeding, an ultrasound procedure may be ordered to get a more extensive picture of the condition of the uterus.
Tags: uterine lining, vaginal bleeding, Vaginal Dryness, affect uterine, affect uterine lining
