If you have finished menopause - the last menstrual period was more than a year ago - you should not have any more menstrual bleeding. Even a certain amount of bleeding is abnormal after menopause. There are several reasons that may cause postmenopausal bleeding.

If you have bleeding in postmenopausal women, make an appointment to see a doctor as soon as possible. This may be caused by a variety of health problems, some of which are very serious.

Causes of postmenopausal bleeding

Several factors relating to health condition may cause bleeding in postmenopausal women, including:

• Polyps. This build-up usually benign, that can develop in the uterus, the cervix, or within the cervical canal and can cause bleeding.
• Endometrial atrophy (thinning of the endometrium). The endometrium, the tissue that lines the wall of the uterus, can become very thin after the menopause because of the lower the levels of estrogen and can cause unexpected bleeding.
• Endometrial hyperplasia. In this case, the endometrium becomes thick, usually as a result of too much estrogen Estrogen - the key to bone health   and too small amount of progesterone Progesterone - norm and pathology And may occur as a result of bleeding. Obesity can be the cause of this problem. In some patients with endometrial hyperplasia Hyperplasia endometrial cancer - requires timely detection and treatment   it may be abnormal cells, which may lead to endometrial cancer (cancer of the uterus).
• Endometrial cancer (cancer of the uterus). Bleeding after menopause may be a sign of endometrial cancer.
• Other reasons. Hormonal therapy, the infection of the uterus or cervix, use of certain medications such as blood thinners, and other types of cancer can cause bleeding in postmenopausal women.

Determining the cause of postmenopausal bleeding

Your doctor can determine the cause of your bleeding, examining your medical history by performing a physical examination, and after spending a few tests. Tests may include:

• Transvaginal ultrasound. During this study, a special imaging device inserted into the vagina so that your doctor can examine the pelvic organs and to find violations.
• Endometrial biopsy. A thin tube is inserted into the uterus and takes her tiny sample that it can be sent to the laboratory and look for anomalies.
• Hysteroscopy. During this test, your doctor uses a tool with a small camera for the study of the inner cavity of the uterus and troubleshooting.
• Dilation and curettage. This study allows the doctor to remove the tissue lining the uterine wall to transfer to the laboratory for analysis.
• Ultrasound and biopsy can be performed in a doctor's office. Hysteroscopy and dilatation and curettage is usually performed in a hospital or outpatient surgical center.

What is the treatment of postmenopausal bleeding

Treatment depends on the cause bleeding. If polyps are the cause, surgery may be needed to remove them. Atrophy of the endometrium can be treated only with medication. Endometrial hyperplasia is treated with medication - hormonal therapy and / or surgery to remove parts of the thickened endometrium. If you have endometrial hyperplasia, then you need to be seen by a doctor on a regular basis to monitor.

How is endometrial cancer

Endometrial cancer can be treated with total hysterectomy, a surgical operation in which the uterus and cervix are removed. In some cases, a portion of the vagina may also be removed as the ovaries and fallopian tubes, together with the nearby lymph nodes. People with advanced cancer of the endometrium should also be examined, hormone therapy or chemotherapy.

Any bleeding in postmenopausal women Postmenopause - is it possible to control it? Regardless of how easy it is to be examined by a physician as soon as possible. Although there is a very good chance that something small is bleeding, there is also a chance that this may be because the cancer. If it is cancer, the sooner treatment is started, the greater the chance that you fully recover.

Only one out of ten women to seek professional help during menopause; many do not require treatment. Those who have the symptoms of menopause are so serious that reduce the quality of life, can help professionals. The method of treatment depends on menopause symptoms, history of the disease and the patient's own preferences.

Hormone replacement therapy

Hormone replacement therapy is effective in treating some of the most common symptoms of menopause, including hot flashes, night sweats, vaginal symptoms and cystitis Cystitis: urgently take action .

Following the name, hormone replacement therapy using estrogen levels during menopause which naturally decreases, causing the symptoms of menopause. There are three main types of hormone replacement therapy:

• Estrogen HRT given to women after surgical removal of the uterus and ovaries.
• Cyclic HRT - women who already had symptoms of menopause, but has not yet run out monthly (along with estrogen Estrogen - the key to bone health   patients taking progestogen).
• Continuous HRT is administered after the onset of menopause.

It can be assigned to the administration of hormones in the form of a cream or gel, tablets, patches or implants.

Tibolone

Tibolone - a synthetic hormone that acts the same way as drugs for HRT. It can be used as an alternative to estrogen and progestogen.

Like HRT, tibolone effectively eliminates the symptoms of menopause such as hot flushes and sweating on the noses, and, in addition, this drug helps prevent fractures of the spine and other bones. It can also enhance the libido, thereby helping to solve some of the problems associated with the menopause in the sexual sphere.

With the acquisition of tibolone to certain risks, including a slight increase in the likelihood of developing breast cancer, uterine cancer and stroke. Tibolone is not suitable for women older than 60 years.

Clonidine

Clonidine - a drug that was originally developed for the treatment of high blood pressure, but it also helps to alleviate symptoms such as hot flashes and night sweats.

This drug has unpleasant side effects such as dry mouth, drowsiness, depression, constipation, and fluid retention in the body, which can lead to the formation of edema. In the absence of a positive result, and / or when the side effects of two weeks, to stop taking the drug.

Vaginal lubricants

Since vaginal dryness Vaginal dryness: Causes and Symptoms   is one of the common signs of menopausal symptoms, vaginal lubricants are a necessary tool in the treatment of menopause symptoms.

Antidepressants

Some antidepressants help against hot flashes, such as venlafaxine, fluoxetine, citalopram, paroxetine.

Side effects of these antidepressants are nausea, dizziness, dry mouth, anxiety Anxiety - how to distinguish normal from disease?   and sleep disorders.

If you pass the HRT, you will need to get tested three months after initiation of therapy and then be surveyed once a year. During the first examination the doctor will ask you about your symptoms have improved you about side effects and weigh and measure your blood pressure; in some cases also requires a blood test. During the annual examination by a doctor reviewing the type of HRT used and, if necessary, make changes; conducting a survey of the chest, as HRT slightly increases the risk of breast cancer.

If the symptoms disappear after one or two years of treatment, the doctor may recommend the abolition of the trial drugs used for hormone replacement therapy. If this does not occur after the deterioration is likely, treatment of menopause, you no longer need.