Vaginal bleeding after menopause could be a red flag for several conditions, from benign (noncancerous) causes to, at worst, endometrial (uterine) cancer. Menopause, technically, is the cessation of periods for a year. Once that happens, you should never have bleeding again. If you do, you should see your gynecologist to be evaluated and treated.
Causes of postmenopausal bleeding. There can be several causes of postmenopausal bleeding. The most common causes are: inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels; cervical or womb polyps – growths that are usually non-cancerous
Treating postcoital bleeding
Some people experience increased discharge during perimenopause and reduced discharge after menopause. Vaginal discharge is often normal, but some characteristics could indicate the presence of an infection or other condition. It is important to determine when discharge is healthy and when to contact a doctor.
SUMMARY AND RECOMMENDATIONS. ● Definition – Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal patient (other than the expected cyclic bleeding that occurs in patients taking combined [ie, estrogen-progestin], cyclic, postmenopausal hormone therapy).
ICD-10 code: N93. 9 Abnormal uterine and vaginal bleeding, unspecified.
The differential diagnosis of postmenopausal bleeding includes many benign and malignant conditions, the most common of which is atrophy, but the most concerning possible etiology is endometrial cancer. As with most malignancies, early diagnosis may lead to a better prognosis.
In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy (a thinning of the uterine lining), vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancer—a malignancy of the uterine lining, but only in a small number of cases.
The ICD-10 code for postmenopausal bleeding is N95. 0 and the CPT code for the endometrial biopsy is 58100.
It's a combination of two different conditions: menorrhagia, which is heavy bleeding during your period, and metrorrhagia, which is when your period lasts more than seven days or you have spotting between periods.
Transvaginal ultrasonography usually is sufficient for an initial evaluation of postmenopausal bleeding if the ultrasound images reveal a thin endometrial echo (less than or equal to 4 mm), given that an endometrial thickness of 4 mm or less has a greater than 99% negative predictive value for endometrial cancer.
Study Provides Closer Look at Postmenopausal Bleeding and Endometrial Cancer. Women experiencing abnormal vaginal bleeding may undergo a transvaginal ultrasound, biopsy, or both, to determine if an endometrial tumor is the cause.
Menopause is usually diagnosed in women over 45 who have not had a period for more than a year. Any bleeding from the vagina after this time needs to be checked by a GP.
The underlying cause of abnormal vaginal bleeding is age-dependent. Ten percent of premenopausal women with abnormal bleeding have a malignant tumor. In contrast, 75% of women over 70 years of age with postmenopausal bleeding have cancer, and the risk rises with age in postmenopausal women.