What causes bleeding after menopause?

After menopause, women will no longer experience vaginal bleeding. If it happens, they can only go to the hospital for a comprehensive physical examination, so that the specific cause of the disease can be diagnosed. It may be caused by inflammation in their body. At this time, the best way is to use some anti-inflammatory and bactericidal drugs to improve the series of symptoms.

1. Clinical diagnosis

The diagnosis of natural menopause is based on a retrospective assessment of perimenopausal women who have had amenorrhea for one year, with or without perimenopausal symptoms, and most do not require auxiliary examinations. Artificial menopause is not difficult to diagnose by analyzing the causes of menopause.

For women who have had amenorrhea for a short period of time, a pelvic examination must be performed to understand the size of the uterus; if necessary, a urine pregnancy test and B-ultrasound examination should be performed to rule out early pregnancy. Because perimenopausal women may occasionally ovulate and become pregnant, it is important not to assume that they are in menopause and treat it as such.

2. Premature ovarian failure

For women who reach menopause before the age of 40, auxiliary examinations are often needed to confirm the diagnosis. Generally, blood FSH>40U/L is used as the basis for diagnosis. To avoid the influence of FSH pulse secretion, blood samples can be drawn twice every other day. The E2 level is low, but there may be fluctuations in the early stage, which can be used for reference. LH increases and can reach above 40U/L after menopause, but its rise is slower than FSH, so FSH/LH>1.

1. Senile vaginitis

The ovaries of normal women of childbearing age secrete estrogen, which causes the vaginal mucosal epithelium to proliferate and thicken, and has strong antibacterial ability. After menopause, women's ovarian function declines, estrogen levels decrease, glycogen content in epithelial cells decreases, and the pH value in the vagina rises, changing from acidic to alkaline, which is not conducive to the survival of lactobacilli in the vagina, resulting in a weakening of the vagina's self-cleaning function. At the same time, due to the atrophy and thinning of the vaginal wall and insufficient blood supply, local resistance is reduced, making it easy to be infected by other parasitic bacteria in the vagina, causing senile vaginitis. It is often caused by common pathogenic bacteria, such as Staphylococcus, Streptococcus, Escherichia coli or anaerobic bacteria.

2. Osteoporosis

After menopause, estrogen deficiency can cause increased bone absorption, intestinal calcium absorption disorders, decreased calcitonin secretion, reduced bone formation and weakened inhibitory effect on osteoclasts, resulting in increased bone loss.

Starting from the menopausal transition period, the average annual bone loss rate is 1% to 3%, or even 5%, which lasts for 5 to 10 years. Then the bone mass is relatively stable, with less loss for about 10 to 20 years. After the age of 70, bone loss accelerates again with aging.

3. Osteoarthritis

The loss of sex hormone protection and abnormal levels of related cytokines in menopausal women play an important role in the pathogenesis of osteoarthritis. Postmenopausal hormone replacement therapy (HRT) has a certain effect on alleviating the pain symptoms of knee osteoarthritis.

4. Menopausal urinary incontinence

As women gradually enter old age from perimenopause to menopause, their organs throughout the body are changing, and the changes in the urinary and reproductive systems are becoming increasingly significant. Estrogen deficiency causes relaxation of the pubic muscles, fascia, ligaments, etc., and a decrease in the function of supporting tissues, making it impossible to maintain normal urethral position and bladder tension. When coughing, holding your breath, constipation, etc. increase abdominal pressure, urine will flow out involuntarily. Its characteristic is that there is no enuresis under normal conditions, but urine flows out automatically when the abdominal pressure suddenly increases.