NYACK, N.Y. — During menopause it is normal to bleed on and off for about six months, however, bleeding after a woman has finished with menopause is not, explained Dr. Ephraim Resnik, Gynecologic Oncologist with Highland Medical, P.C.
“If you see even a tiny amount of blood starting a year after you have had your last menstrual period and any time thereafter, see your doctor,” he said. In many cases, bleeding after menopause is an easily treatable condition. However, in up to 20 percent of cases, postmenopausal bleeding can be a sign of uterine or endometrial cancer, Resnik said. An estimated 60,050 women were diagnosed with endometrial cancer in the U.S. in 2016, according to the National Cancer Institute.
In order to diagnose the cause of postmenopausal bleeding, the doctor will first ask about a patient’s medical history and consider various factors. “The majority of endometrial cancers occur about a decade after menopause, or around age 60,” said Resnik. “Women with hypertension and diabetes, as well as those who are overweight, are also much more prone to developing endometrial cancer.”
The doctor will then conduct a thorough physical exam to see if the blood may be coming from somewhere other than the uterus. For example, blood can come from hemorrhoids or from polyps in the urethra, which is the tube that conducts urine from the bladder to the outside of the body.
Treatment for postmenopausal bleeding depends on the cause. If polyps are causing the bleeding, they are removed with minimally invasive surgery. Fibroids may also be treated by placing medications through a catheter into a blood vessel to block blood flow to an area of the body, through minimally invasive surgery, or with a surgical removal of the uterus.
In most cases, treatment for endometrial cancer is a total hysterectomy, which involves removing the uterus, cervix and ovaries. Resnik noted that today the overwhelming majority of hysterectomies performed because of endometrial cancer are done with minimally invasive laparoscopic surgery that involves small incisions. Some doctors perform robotic-assisted laparoscopic hysterectomy, using a computer to control the surgical instruments.
“Laparoscopic and robotic surgery provides for a quicker discharge from the hospital, and a faster recovery and return to normal function, with better cosmetic results,” he said.