WHAT YOU NEED TO KNOW:

What do I need to know about postmenopausal bleeding? Postmenopausal bleeding is bleeding that occurs after menopause. A woman who has not had a period for a full year after the age of 40 is considered to be in menopause. Postmenopausal bleeding may range from spotting to very heavy bleeding.

What causes postmenopausal bleeding?

• Thinning of the endometrium (lining of the uterus) called endometrial atrophy
  
  
• Polyps (noncancerous growths) that develop on the inner wall of your uterus or cervix
  
  
• Hormone replacement therapy
  
  
• Abnormal thickening of the endometrium called endometrial hyperplasia
  
  
• Tamoxifen (medicine used to treat breast cancer)
  
  
• Cervical, endometrial, or uterine cancer

How is postmenopausal bleeding diagnosed? Your healthcare provider will ask about medical conditions that you have, and that run in your family. He will also do a pelvic exam to check for problems with your cervix, uterus, and ovaries. You may also need any of the following:

• An ultrasound uses sound waves to show pictures of your uterus on a monitor. Your healthcare provider may place saline fluid into your uterus with a catheter. The fluid helps show more detail in the ultrasound pictures of your uterus.
  
  
• Endometrial biopsy is used to collect a sample of cells from the inside of your uterus to be tested for cancer.
  
  
• Hysteroscopy is a procedure that is done to look inside your uterus. A small scope with a light and camera is placed into your vagina and cervix. Liquid or gas may be put through the scope to help healthcare providers see better.
  
  
• Dilation and curettage (D&C) is a procedure to remove tissue from the lining of your uterus. The tissue is sent to a lab for tests.

How is postmenopausal bleeding treated? Treatment depends on the cause of your postmenopausal bleeding. If you have polyps, you may need surgery to remove them. Endometrial atrophy can be treated with medicines. Endometrial hyperplasia may be treated with progestin hormone therapy. Surgery to remove your uterus will be needed if you have endometrial or uterine cancer. Your fallopian tubes, ovaries, and nearby lymph nodes may also be removed.

When should I contact my healthcare provider?

• You continue to have vaginal bleeding, even with treatment.
  
  
• You have pain in your abdomen or pelvis.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.