What causes postmenopausal bleeding?

Female friends will stop bleeding after the age of 50. So do you know what postmenopausal bleeding is? Is postmenopausal bleeding cancer? What is the cause of postmenopausal bleeding? Let us learn about it together.

1. Malignant tumors: In the past, it was believed that the incidence of malignant tumors in postmenopausal uterine bleeding was very high, so it was believed that postmenopausal uterine bleeding was a signal of malignant disease. However, in recent years, it has been found that malignant tumors are only a small part of patients with postmenopausal bleeding. Among the malignant tumors that can cause postmenopausal uterine bleeding, endometrial cancer is the most common, followed by cervical cancer, and ovarian malignant tumors are relatively rare. Although the proportion of malignant tumors in patients with postmenopausal uterine bleeding is not very high, we still need to be vigilant. For patients with unexplained postmenopausal uterine bleeding, repeated examinations and strict follow-up are required for early diagnosis and treatment to improve the quality of life of elderly women.

2. Functional uterine bleeding: According to clinical investigation results, more than half of patients with postmenopausal uterine bleeding have no obvious organic lesions, but functional uterine bleeding caused by endocrine disorders has become the main cause of postmenopausal bleeding. Medical experts explain this as follows: the follicle-stimulating hormone in postmenopausal women is high, which stimulates the interstitial cells in the ovaries to secrete estrogen, which produces an accumulation and stimulation effect on the endometrium, leading to different degrees of hyperplasia of the endometrium and cervix, and even the formation of polyps. However, the secretion of this hormone is unstable and volatile, so when the hormone secretion level decreases, the hyperplasia of the endometrium will suddenly stop and slough bleeding will occur, forming dysfunctional uterine bleeding. It can be seen that after excluding organic lesions, patients with postmenopausal uterine bleeding should first undergo vaginal B-ultrasound examination to understand the thickness of the endometrium, and curettage if necessary to assist in the diagnosis of functional uterine bleeding and differentiation from endometrial cancer. Under normal circumstances, although functional uterine bleeding has endometrial hyperplasia, the thickness of the endometrium generally does not exceed 4 mm. If it is more than 4 mm, a diagnostic curettage should be performed to rule out or detect endometrial cancer.

3. Genital tract inflammation: With the extension of menopause, the level of sex hormones in women is getting lower and lower, the endometrium is gradually shrinking, and the vaginal mucosa is also shrinking. The atrophy of the endometrium and vaginal mucosa causes the local resistance to decrease and is susceptible to invasion by pathogenic microorganisms such as bacteria and chlamydia, leading to endometritis, cervicitis and vaginitis. On the basis of inflammation, superficial capillaries are easily damaged, and a few can form superficial ulcers, causing bleeding. About 1/3 of postmenopausal uterine bleeding is related to genital tract inflammation. Therefore, on the one hand, it is necessary to strengthen the health care of the reproductive tract after menopause, and on the other hand, a small amount of sex hormone supplementation can be given. Preventing the occurrence and development of genital tract inflammation is the key. At the same time, when examining patients with postmenopausal uterine bleeding, attention should be paid to whether there is genital tract inflammation. Once diagnosed, it should be actively treated to reduce bleeding.

4. Other causes: including vaginal caruncle, genital tract trauma, uterine prolapse, benign ovarian tumors, rupture of endometrial glandular cysts, etc., can all be one of the causes of postmenopausal uterine bleeding. For these situations, we should understand them, carefully investigate, diagnose in time and actively treat them to reduce the incidence of postmenopausal uterine bleeding.