Post Menopausal Bleeding
Post-Menopausal Bleeding is not an uncommon clinical presentation.
Contributory factors for post-menopausal bleeding are:
- Increased life expectancy of women – 1/3rd of women’s life now is an after menopause.
- Obesity – Increasing number of women seeking help (or) reassurance for this problem due to increased awareness.
- PMB occurs in approximately 3% of post-menopause women – Any vaginal bleeding that occurs 6months after the last period should be investigated.
Why is it important to investigate?
Women with PMB have 10-15% chance of having endometrial cancer.
90% of endometrial cancer in the post-menopause period present with PMB.
Hence immediate evaluation is required for early detection and better outcome.
The presence of other comorbidities like
- No pregnancies
- Mature at early age
- Late menopause Increases the risk of endometrial cancer.
The principle aim of evaluation is to identify (or) exclude endometrial cancer.
Post-menopausal women aged 65 years (or) over had a much greater chance of having endometrial cancer than woman aged below 65 years if they presented with recurrent PMB.
Women on tamoxifen for the treatment of breast cancer and more recently for the prevention of breast cancer have an increased risk of endometrial cancer (211,000 treated women) so any PMB in these women needs immediate evaluation for early detection and better outcome.
Entering menopause is the time to consider preventive health and positive health steps.
Menopause is no more a strong transition to advanced medicine and it is a stage of the end of first adulthood and a beginning of second adulthood with freedom.
Decreased level of female hormones have a profound effect on bones, heart, brain, breast, eyes and blood and produce problems such as hot flushes, night sweats, irritability, sleeplessness, vaginal dryness and sexual problem along with bleeding problem (menstrual).
Hormone replacement therapy (HRT) or phytoestrogens is altogether a new scenario.
HRT can be used effectively in ultrashort doses in various forms and combinations which can be tailored with close supervision, where all women can see it right.
Anti-aging diet with forty water supplement and amplification alleviate menopausal symptoms.
Physical exercise has to be tailored to the individual to keep the physical state in a toned up condition.
The value of regular medical changes cannot be undermined
- Blood pressure
- Blood sugar
- Blood lipids
Regularity generally means once a year medical checkup and whenever the need arises.
The saying “prevention is better than cure” justifies its message best after the age of 40. That’s why the term we used is “well woman screening”.
“Open up with your menopause specialist” it is easier to change the attitude towards aging than fighting with age.