Monday, March 30, 2009

Post-menopausal bleed

55 year old lady presented with post-menopausal bleed. Ultrasound showed a 4.6cm fibroid in her uterus.
Post menopausal bleeding is common and affects as many as 30% of post menopausal women.The most common cause is HRT. The supplemental hormones stimulate the uterine lining in the same manner as would the natural hormones found in a healthy pre-menopausal female.
In women not on HRT, around 90% will have no obvious cause, or prove to be caused by a minor problem, often not requiring treatment. In the remaining 10%, the most common cause for post menopausal bleeding is atrophic vaginitis, which is an inflammation of the lining of the vagina, caused by lower levels of oestrogen. This is followed by polyps and fibroids as the 2nd most common cause. Polyps and fibroids can occur in the uterus, and may cause irregular post
menopausal bleeding, and are usually harmless.

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