Vaginal bleeding after menopause must be paid attention to. But not to say that all postmenopausal vaginal bleeding has serious problems. Now carry out simple science popularization on personal work experience. Vaginal bleeding after menopause is a common symptom of a large group of gynecological diseases. If this happens, you must go to the gynecological clinic for related examinations.
First of all, it is necessary to determine whether the bleeding comes from the vagina. Many women seek medical attention because they find blood on their underwear. In addition to vaginal bleeding, it may also be bleeding from the urethra and anus. This is generally easier to judge. When there is bleeding, the outpatient doctor uses a speculum to expose the vagina. If there is no blood, you need to consider the possibility of bleeding in other parts. I once encountered two patients who came to the hospital in the emergency department at night, and found that there was blood flowing from the lower body during the shower. Later, there was no blood in the vagina and the B-ultrasonic examination showed no abnormalities in the gynecology department. Later, the urology department was recommended to see a doctor and both were diagnosed as bladder. Tumor. In addition, some patients have bleeding caused by hemorrhoids and anal tumors.
Secondly, if it is determined that it is blood from the vagina, it is necessary to carefully observe the characteristics of the blood.
If it is a pink vaginal discharge, it is accompanied by sexual pain, especially tingling, most of which should be considered as senile vaginitis. This situation is very common in clinical practice. Due to the decline in hormone levels after menopause, vaginal mucosa shrinks, which is easy to occur Inflammation, especially during sexual life, is easy to bruise, resulting in a small amount of bleeding. During gynecological examination, you can see spotted or small pieces of bleeding on the vaginal wall. Treatment is relatively simple, suppositories can be used locally, and hormones can be used locally when necessary.
If the bleeding is small, dark red or coffee-colored, it often indicates that the bleeding site is relatively high, and the accumulation time is longer, resulting in the appearance of old blood. In this case, blood from the uterine cavity should be considered. Sometimes it can be used in the gynecological examination. If you see blood leaking from the cervical canal, you need a B-ultrasound to understand the condition of the uterine cavity, especially the thickness of the endometrium (the endometrium after menopause should usually be around 1-2mm), whether there is any abnormal space, whether There is uterine cavity separation and uterine effusion. If the above conditions occur, endometrial or space-occupying biopsy (diagnostic curettage or hysteroscopy) is required to finally diagnose or rule out abnormal endometrial hyperplasia (especially caused by taking exogenous hormones) Endometrial hyperplasia, including simple hyperplasia, complex hyperplasia and atypical hyperplasia), endometrial cancer.
If the bleeding in the vagina is bright red, with a large amount or even with blood clots, the cervix should be checked, combined with HPV, TCT, and biopsy or colposcopy when necessary to rule out cervical cancer. This type of patient is also often seen in the emergency department. Because many women do not routinely perform regular gynecological examinations after menopause, cervical tumors often progress to a certain extent, and only go to the doctor when bleeding occurs, which delays the best time for treatment.
In addition, other causes of postmenopausal vaginal bleeding may be ovarian tumors, especially tumors that secrete estrogen, such as granulosa cell tumors, etc., and also because of taking estrogen or estrogen-like drugs, health products, etc. , The doctor needs to know the medical history in detail to determine.
To sum up, for postmenopausal vaginal bleeding, you must go to the gynecology department to clarify the location and nature of the bleeding. The focus is to check the vaginal wall, cervix, and endometrium (including thickness, whether the echo is uniform, whether there is a space, whether there is a uterine cavity Effusion, etc.), ovaries, etc., and then choose more targeted examinations, such as diagnosing curettage, colposcopy, hysteroscopy, etc., and finally clarify the cause and treat in time.