Postmenopausal bleeding in the elderly

Women's bodies are different from men's due to some special functions. There are some special structures and constructions. For example, menstruation is the most familiar to female friends. Menstruation comes during puberty, and menopause will end after a certain age. So let’s take a look at what causes postmenopausal bleeding in the elderly.

When menstruation stops for more than a year at around 50-55 years old, we are considered to have entered the late stage of despair. The most common sites of postmenopausal vaginal bleeding are the vulva, vagina, and uterus. The most common of these is uterine bleeding, and it is also the most complicated. The more common benign diseases include senile vaginitis, endometritis, cervical polyps, endometrial polyps, uterine stroke syndrome, and prolonged placement of intrauterine contraceptive devices after menopause; the more common malignant diseases include endometrial cancer, cervical cancer, ovarian cancer, fallopian tube cancer, etc. Among them, endometrial cancer accounts for about 80% of all postmenopausal bleeding.

Finding out the cause of postmenopausal vaginal bleeding in time is the key to correctly treating this type of disease. Vaginal bleeding is not an isolated symptom, but a disease or even an external manifestation of multiple diseases. Understanding the disease through symptoms and recognizing the disease through external manifestations is possible in many diseases.

Benign vaginal bleeding after menopause generally has no obvious systemic symptoms, the bleeding is not too severe, cachexia-like constitution rarely occurs, and there is no obvious abnormality in the leucorrhea, unless it is accompanied by bacterial infection, there will be an abnormal odor. The amount of bleeding in senile vaginitis is small, often with spotting of blood, and is accompanied by itching and burning sensation of the vulva, or distension and discomfort in the lower abdomen. Sometimes Trichomonas and fungi can be found, but the size, shape and texture of the uterus are normal. Endometritis causes regular vaginal bleeding. About half of the patients experience lower abdominal pain or heaviness, increased vaginal discharge, and if it is an acute case, fever may also occur. Gynecological examination shows no obvious abnormalities, and antibiotic treatment has a significant effect. If the intrauterine pyometra is really intractable, hysterectomy can be considered. We have performed several cases with good results. Cervical polyps are also a common cause of bleeding. Bleeding from this disease often occurs during sexual intercourse. Gynecological examination or B-ultrasound examination can detect polyps on the cervix, which are different from malignant tumors. A biopsy can be performed when in doubt. Uterine stroke syndrome, obstructed bleeding is very similar to menstruation, with a slightly larger amount of bleeding. If complicated by infection, low fever and leukocytosis may occur. This disease has symptoms of arteriosclerosis and abnormal heart function. A series of symptoms of heart failure such as cough, dyspnea, palpitations, heart enlargement, lower limb edema, and liver enlargement often occur. The uterus is normal in size and there is no mass in the pelvic cavity. Diagnostic curettage confirmed endometrial necrotizing bleeding.

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