Clinical Treatment for Post Menopausal Bleeding
Channel: BioBalance Healthcast
Date: 2019-09-02

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/

Before menopause women have periods every 21-30 days, or monthly.  Most women can anticipate when they are going to have a period and are prepared for it, so it becomes a fact of life. 

Uterine bleeding is necessary monthly because human females are fertile once a month, they prepare the egg for the first 14 days of their cycle, the egg is ovulated or pushed out of the ovary and travels down the fallopian tube where it is fertilized by sperm that are deposited in the vagina. During the second 14 days of the cycle, the uterus prepares a thick lining under the influence of high estradiol and progesterone levels, so a fertilized egg can nestle in and begin to divide and eventually become a human baby.

 A human egg is fertile for only about 36 hours after ovulation and if it is not fertilized it disintegrates, and   when it gets to the uterus it doesn’t need the lining of the uterus to nurture a baby, so Estradiol and Progesterone drop precipitously and the signal to the uterus is to shed the uterine lining.  With no estradiol or progesterone to feed the lining it bleeds out the uterus and we call that a period.

This cycle goes on and on unless a woman is on the pill during which time the orchestrated elevations and decreases of the female hormones coming from the ovary are suppressed.  The pill gives women a very low estrogen and progesterone blood level, which prevents the increase and decrease of the female hormones and the lining of the uterus does not thicken.  Of course, this is not a perfect program, and some women spot and bleed all the time during their cycle.  This can be because their own estrogen and progesterone is not suppressed enough, and their lining gets too thick, or their own estradiol is too low, and their lining is too thin, and they spot from a fragile and thin uterine lining.  

Before menopause other problems can come into play that make the uterus misbehave, such as benign growths like polyps and fibroids.  These growths can happen to anyone…it is no one’s fault, but they don’t behave like they should and people with these growths often bleed off and on for no reason and no way to predict the pattern.  Often, they have to be surgically removed to stop an irregular bleeding problem.

Post-menopausal bleeding is defined as uterine bleeding after a woman has been menopausal for a year or more. Post-menopausal bleeding is often a side effect of any type of estradiol and progestin or progesterone postmenopausal hormone therapy.  PMP Bleeding is usually a bother, and not a sign of cancer or a uterine fibroid or polyp. If a woman has two episodes of bleeding after menopause her doctor must make sure her problem is benign by a uterine ultrasound and or a uterine biopsy in the office or a D&C to clean the uterus out.  These procedures reassure the doctor and patient that the bleeding is not a serious problem, and in the case of a D&C, this procedure removes all of the tissue from the uterus to both diagnose and treat the uterine bleeding.

Any bleeding after a D&C for the following year is not considered cancer because uterine cancer is slow growing and won’t grow from nothing to cancer in one year.