McKeown Medical
167 Bath Street, Glasgow, G2 4SQ
Post-Menopausal Bleeding
Post-menopausal bleeding is defined as any vaginal bleeding that occurs more than 12 months after a woman’s last menstrual period. This symptom should never be ignored, as it may be an indication of underlying health concerns, including certain female cancers.
Post-menopausal bleeding is defined as any vaginal bleeding that occurs more than 12 months after a woman’s last menstrual period. This symptom should never be ignored, as it may be an indication of underlying health concerns, including certain female cancers.
Post-menopausal bleeding
If you experience post-menopausal bleeding, it is critical to have it checked out as soon as possible. Here, Dr Iain Martin discusses what it is, why it’s so important to have it investigated quickly and thoroughly, and how we can help at McKeown Medical.
What causes post-menopausal bleeding?
Post-menopausal bleeding can have various causes, some of which are benign, while others may require urgent attention.
Common causes include:
Vaginal Atrophy: Lower oestrogen levels after the menopause lead to reduced vaginal lubrication and dryness. This can result in thinning and inflammation of the vaginal walls which may cause bleeding.
Endometrial Polyps: Overgrowths of the womb lining that can cause bleeding. Whilst these are benign in the majority of cases, they can develop pre-cancerous or cancerous changes.
Hormone Replacement Therapy (HRT): Certain forms of HRT may lead to unexpected bleeding but it is important to have this checked to ensure there is not something more serious going on.
Endometrial Hyperplasia: Thickening of the uterine lining, which can develop into endometrial cancer.
Endometrial Cancer: A serious but less common cause of post-menopausal bleeding that requires prompt diagnosis and treatment.
Management and diagnostic approach
It is essential that anyone experiencing post-menopausal bleeding seeks medical advice promptly. At McKeown Medical, we follow a structured protocol to ensure a thorough and timely diagnosis:
- Initial Consultation and Ultrasound Scan: During your first appointment, you will have a consultation with our consultant gynaecologist, including an ultrasound scan to assess the thickness and appearance of the lining of the womb.
- Diagnostic Hysteroscopy: Based on the ultrasound results, we may recommend a diagnostic hysteroscopy to take a direct look inside the womb. This minimally invasive procedure allows us to identify any abnormalities clearly.
- Treatment and Biopsy: If visible abnormalities such as polyps are detected, we can often treat these during the same procedure. If there are any suspicious areas, a biopsy will be taken to check for abnormal or cancerous cells.
- Referral for Further Care: If the biopsy reveals any sinister findings, we will promptly refer you to your local Cancer Team in the NHS for ongoing management.
What is vaginal atrophy?
Vaginal atrophy is a condition characterised by the thinning, drying, and inflammation of the vaginal walls. It is primarily caused by a decrease in oestrogen levels, which commonly occurs after menopause. This reduction in oestrogen can lead to symptoms such as vaginal dryness, itching, burning, discomfort during intercourse, and spotting or bleeding.
Treatment usually includes the use of topical oestrogen therapies, such as creams or pessaries to replenish oestrogen levels in the vaginal skin. Non-hormonal lubricants and moisturisers can also help alleviate symptoms. Lifestyle modifications, including staying hydrated and avoiding irritants like perfumed products, may also support symptom management.
What are endometrial polyps?
Endometrial polyps are growths that develop in the lining of the uterus. They are a common cause of post-menopausal bleeding and may also cause irregular bleeding or spotting. These growths are typically caused by hormonal imbalances that lead to overgrowth of the endometrial tissue.
Polyps are usually diagnosed through an ultrasound or a hysteroscopy. Treatment often involves removing the polyps during a hysteroscopy using the MyoSure® device, especially if they cause symptoms or appear suspicious. Removal is a simple procedure that can often be done on an outpatient basis, providing relief and a definitive diagnosis.
HRT-related bleeding
Hormone Replacement Therapy (HRT) can sometimes cause post-menopausal bleeding as a side effect, especially in the first few months of starting HRT or after a change in dose.
Diagnosis involves reviewing the HRT regimen and ruling out other potential causes of bleeding. Adjustments to the type or dose of HRT may resolve the issue. In cases where bleeding persists, further evaluation with ultrasound or hysteroscopy may be necessary to exclude other underlying conditions.
What is endometrial hyperplasia?
Endometrial hyperplasia is a condition characterised by the thickening of the uterine lining, often caused by prolonged exposure to oestrogen without the balancing effect of progesterone. This can occur in women taking unopposed oestrogen HRT or in those with hormonal imbalances resulting from other medical conditions such as obesity or polycystic ovarian syndrome. Symptoms include heavy or irregular bleeding and, in some cases, post-menopausal bleeding.
Diagnosis is made through ultrasound and confirmed with a biopsy of the womb lining. Treatment depends on the severity and type of hyperplasia. In simple cases, progesterone hormone therapy may be prescribed to balance hormones. In more complex cases, surgical options such as hysterectomy are considered.
What is endometrial cancer?
Endometrial cancer is the most serious potential cause of post-menopausal bleeding. It occurs when cancerous cells develop in the lining of the uterus. The most common symptom is post-menopausal bleeding, although it can also occur before the menopause or during the perimenopause. Risk factors include obesity, diabetes, high blood pressure, unopposed oestrogen therapy, and a family history of endometrial or colorectal cancer.
Diagnosis is confirmed through a combination of ultrasound, hysteroscopy, and biopsy. Treatment depends on the stage of the cancer and may include surgery, radiation, chemotherapy, or a combination of these. Early detection significantly improves the prognosis, highlighting the importance of prompt evaluation for any post-menopausal bleeding.
By removing the barriers often associated with hospital-based procedures, we enable our patients to make informed decisions about their health and choose treatments that align with their lifestyles and priorities.
Our Services
While diagnostic hysteroscopy services are available through the NHS, waiting times can be lengthy. At our clinic, we are committed to providing rapid access to diagnostic care, ensuring that all patients are seen and have their hysteroscopy completed within two weeks of initial contact.
By choosing our services, you can benefit from expert care delivered promptly, giving you the reassurance and clarity you need to address your health concerns. If you are experiencing post-menopausal bleeding please make sure you tell your doctor straight away.
Treatment Options
At McKeown Medical, we offer cutting-edge gynaecological treatments with an ambulatory approach, making it a convenient and accessible choice.
Start your journey to better health
If you’re experiencing post-menopausal bleeding, it’s important that you seek medical advice promptly. Contact us today to schedule a consultation with thorough diagnostics to give you the reassurance and clarity you need to address your concerns.
Your Expert Team
Consultant Gynaecologist
Dr. Iain Martin
Dr. Iain Martin is a consultant gynaecologist with a specialist interest in minimally-invasive gynaecology treatments. With years of experience and a dedication to improving women’s healthcare, Dr. Martin has become a trusted name in his field. His pioneering work in Scotland has made advanced, minimally- invasive treatments accessible to more women than ever before. Under Dr. Martin’s guidance, our clinic is setting a new standard for private gynaecological care.
Consultant Gynaecologist
Dr. Iain Martin
Dr. Iain Martin is a consultant gynaecologist with a specialist interest in minimally-invasive gynaecology treatments. With years of experience and a dedication to improving women’s healthcare, Dr. Martin has become a trusted name in his field. His pioneering work in Scotland has made advanced, minimally- invasive treatments accessible to more women than ever before. Under Dr. Martin’s guidance, our clinic is setting a new standard for private gynaecological care.
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