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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Lower Back Pain And Bleeding After Achieving Menopause. Pap Smear Test Came Back Normal. Where Does Problem Lie?

Hi was wondering im a 57 yr old female been thru the change already but ive been very concerned ive started bleeding again and my lower backs been killing me I had a pap smear done and it came back ok ....just concerned on maybe whats going on...thanks
Tue, 3 Dec 2013
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Anesthesiologist,  's  Response
Hello,
Even a little spotting is not normal after menopause.
Thus you need further evaluation.
It may be due to one of the following.
1. atrophic vaginitis
2. endometrial atrophy
Both caused by lower oestrogen levels
3. Cervical or womb polyps – these growths, which are usually non-cancerous, can form in the cervix of uterus or womb
4. endometrial hyperplasia caused by hormone replacement therapy
5. abnormalities of the cervix or the womb
6. Rarely Cervial or Uterine cancer.

It is essential to rule out cancer. Because One in 10 Post menopausal bleeding is usually resulting from either cervical or Uterine cancer.
You need the following investigations and physical evaluation.
1. Transvaginal ultrasound
2. Endometrial biopsy
3. Hysteroscopy
4. D&C (dilation and curettage)
5. Ultrasound and if needed biopsy.

Then with these investigations you have to consult Gynaecologist.

Hope this helps.
Please write back for further queries.
Wishing you good health.
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Have Lower Back Pain And Bleeding After Achieving Menopause. Pap Smear Test Came Back Normal. Where Does Problem Lie?

Hello, Even a little spotting is not normal after menopause. Thus you need further evaluation. It may be due to one of the following. 1. atrophic vaginitis 2. endometrial atrophy Both caused by lower oestrogen levels 3. Cervical or womb polyps – these growths, which are usually non-cancerous, can form in the cervix of uterus or womb 4. endometrial hyperplasia caused by hormone replacement therapy 5. abnormalities of the cervix or the womb 6. Rarely Cervial or Uterine cancer. It is essential to rule out cancer. Because One in 10 Post menopausal bleeding is usually resulting from either cervical or Uterine cancer. You need the following investigations and physical evaluation. 1. Transvaginal ultrasound 2. Endometrial biopsy 3. Hysteroscopy 4. D&C (dilation and curettage) 5. Ultrasound and if needed biopsy. Then with these investigations you have to consult Gynaecologist. Hope this helps. Please write back for further queries. Wishing you good health.