So I get this call from Estonia ? Does anyone know where Estonia is? Well anyway it’s 2:30 Sunday morning and my pager goes off.
My darling patient is in Estonia for a wedding and while there she has an episode of bleeding. Not too much but bright red. No cramps or symptoms of her period of course because she is 55 and postmenopausal. Pretty sure I mentioned that. She was alarmed and wanted to know what to do.
So what is postmenopausal bleeding?
- How do you define it?
- What does it mean?
- What should you as a patient do?
Postmenopausal bleeding: Any bloody discharge large amount or
small amount, one year or longer after menopause.
So what does it mean?
Well it can mean many things. Most of them benign, but it is also a warning sign as well. It can be an early sign of Uterine or Endometrial cancer.
This is not the time to say its probably nothing, even though it probably is nothing. It’s the time too call your doctor and let them tell you it’s nothing, but not before they evaluate you.
Some conditions in which you see vaginal bleeding?
- Injury…vaginal cuts or tears from exercise, intercourse, a fall etc.
- Vaginal or vulvar infections…
- Severe yeast infections such as inclusions cysts…
- Urinary tract infections….
- Hemmoroids, or rectal fissures…..
- Hormonal bleeding……. A mini period that you can get is the best way to explain it -Or if you are on medical hormone therapy you can experience bleeding.
- Endometrial Polyps.. A gland in the uterus with an abnormal affinity to estrogen ( even the smallest of estrogen). These must be diagnosed and removed as there is a small chance of progressing into a cancer.
- Uterine cancer……. No need to explain this. But the earlier it is found the better the chance of successful treatment
So what should you as a patient do?
Call your doctor aka healthcare provider ( whatever that is) . A term made up by insurers. You should be seen, examined and evaluated. This might mean bloods, urine tests, a pelvic sonogram, a physical and of course an Endometrial Biopsy.
These are simple things that can be done in order to be managed and treated completely thoroughly and satisfactorily.
However, you must pick up the phone, make that call! …. Even if its from Estonia.
My patient has her appointment the day after she arrives home from her trip.
Dr. Miriam Greene practices obstetrics and gynecology in New York City and is Board Certified by the American Board of Obstetrics and Gynecology.
You can listen to Dr. Greene’s show “Sexual Health and Wellbeing“, Mondays between 12-2pm on Sirius radio xm81.