Any bleeding that occurs outside the menstrual cycle in women should be considered abnormal and taken seriously. However, in a woman who has entered the menopause physiologically, this bleeding becomes even more important as it may indicate cancer.
Acıbadem Taksim Hospital Gynecology, Obstetrics and Gynecology Oncology Specialist Prof. Dr. İlkkan Dünder draws attention to the fact that no matter how little or more, long or short, red or brown vaginal bleeding during menopause, a doctor should be consulted as soon as possible.
Menopause is a special process for every woman. Having detailed information about this period, in which they are affected both psychologically and physiologically, also means being prepared for possible risks.
Time of menopause
While in developed countries the average age of menopause is 49-50, women in Turkey enter menopause between the ages of 47-49. According to experts, menopause is considered if there is no bleeding for 6 months after the last menstruation.
Postmenopausal bleeding is not seen as normal
Bleeding after menopause is considered pathological and the underlying cause is definitely sought. The day, duration and amount of these bleedings are also very important. Gynecology, Obstetrics and Gynecological Oncology Specialist Prof. Dr. İlkkan Dünder says that women may not care about bleeding during this period, considering that they still have not entered menopause. However, if, for example, a 49-year-old woman does not have a period for two months and bleeds in the following month, this is already considered perimenopause, not menopause.
Postmenopausal bleeding may be caused by a benign or malignant tumor!
Pathological hemorrhages that occur after a 6-month bleeding-free period can be caused by benign or malignant causes.
Bleeding caused by benign causes can occur for two reasons:
1. Bleeding due to external hormones and similar drugs
2. Bleeding from benign diseases.
Causes of hormone or drug-related bleeding during menopause
Prof. Dr. İlkkan Dünder lists the diseases that cause bleeding during menopause as follows: “A benign polyp or vaginal cancer in the chamber we call the vagina, a wound or cancer that develops in the cervix, any benign or future malignant disease that may develop in the uterine canal. Tumors that can transform can be a benign tumor that develops in the ovary and produces estrogen, as well as a wide range of ovarian tumors leading to ovarian cancer can cause bleeding. Apart from this, although rare, bleeding may occur due to general systemic diseases. In addition, in the advanced stages of menopause, it may occur in benign bleeding due to atrophy of the tissues.
A doctor should be consulted as soon as there is bleeding
If a woman does not use estrogen (hormone therapy) drugs to relieve her menopausal complaints, but if she has bleeding, different reasons are sought. Therefore, it is necessary to go to the doctor as soon as there is bleeding. In addition to the general examination, transvaginal ultrasonography is also used to detect the problem in women who apply.
The thickness of the intrauterine tissue is important in transvavinal ultrasonography. Intrauterine thickness can be accepted up to a certain level for a woman using estrogen. For this reason, while tissue thickness up to 5 mm is considered normal and followed in women who do not use any medication, intrauterine biopsy is absolutely necessary for thickenings of 8 mm and above.
Diabetes patients, obese people, women who have never given birth or breastfed before have an increased risk of intrauterine cancer. Therefore, bleeding is more common in women in the risk group.
When should a biopsy be done?
K , who said that a biopsy should be performed regardless of the amount and duration of bleeding, regardless of the amount and duration of the bleeding, although no medication is used, Prof. Dr. İlkkan Dünder , “In all bleedings that occur from the day of the woman’s menopause until the end of her life; Although about 95 percent of it is well-caused bleeding if it is not due to externally taken drugs, 5 percent can be caused by cancer. The ideal reagent for this can be established by biopsy. A biopsy is a simple procedure that takes a very short time and should not be feared. However, biopsy can be painful in menopausal women as the uterus shrinks and the channels narrow, so it is preferred to perform the biopsy under anesthesia.
The duration or amount of bleeding is not decisive
In patients with gynecological cancer , vaginal bleeding usually occurs in the earliest stages. For this reason, no matter how little or more, long or short, red or brown bleeding occurs during menopause, a doctor should be consulted as soon as possible.