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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Menopause, Taken Kenalog Injections, Bleeding Started. Can It Escalate Uterine Cancer?

Have you heard of Kenalog causing post menopausal bleeding? My Dr. has not, yet I read all sorts of info that it does. I have two Kenalog shots and one Medrol dose pak within a month, 10 days after last shot, started to bleed. I am aware of the other things it could be and do have appt with gyn. I am wondering if any uterine cancer was already present, would Kenalog cause it to escalate aslo.
Thu, 4 Oct 2012
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OBGYN, Maternal and Fetal Medicine,  's  Response
Dear emoody4154,
Yes, Kenalog and Medrol can cause post menopausal bleeding (PMB). Remember that they both are corticosteroids and in the causes of medications that cause PMB they are quite prominent.
Yes, if there is any uterine cancer already existing, it could theoretically worsen it too.
But it is unlikely to be the cause of the uterine cancer.

Any patient with an existing uterine cancer is bound to show its presence by an abnormal bleeding. Bleeding after menopause is always considered as abnormal and needs investigation.
These 2 statements are very important to know, even for the future.

At this point let me share that only 10-11% cases with PMB actually have cancer. Look at it this way - about 90% of the causes of PMB are NOT cancer and are benign in nature. Yet, all patients of PMB must be evaluated to rule out the possibility of cancer.

In this regard the first step would be few blood tests to rule out medical problems and bleeding/coagulation abnormalities followed by A PAP smear and a transvaginal ultrasound. If the endometrial lining is more than 4-5 mm thick, a Hysteroscopic biopsy is required. So an invasive test of biopsy may be required only if lining of uterus is thick.

Please know that had you had pre-existing uterine cancer, you would have had bleeding earlier too. Simple tests can rule it out. Since corticosteroids can cause PMB without there being cancer, relax till you consult with your doctor.
I hope this answers your query.
Take care.
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Menopause, Taken Kenalog Injections, Bleeding Started. Can It Escalate Uterine Cancer?

Dear emoody4154, Yes, Kenalog and Medrol can cause post menopausal bleeding (PMB). Remember that they both are corticosteroids and in the causes of medications that cause PMB they are quite prominent. Yes, if there is any uterine cancer already existing, it could theoretically worsen it too. But it is unlikely to be the cause of the uterine cancer. Any patient with an existing uterine cancer is bound to show its presence by an abnormal bleeding. Bleeding after menopause is always considered as abnormal and needs investigation. These 2 statements are very important to know, even for the future. At this point let me share that only 10-11% cases with PMB actually have cancer. Look at it this way - about 90% of the causes of PMB are NOT cancer and are benign in nature. Yet, all patients of PMB must be evaluated to rule out the possibility of cancer. In this regard the first step would be few blood tests to rule out medical problems and bleeding/coagulation abnormalities followed by A PAP smear and a transvaginal ultrasound. If the endometrial lining is more than 4-5 mm thick, a Hysteroscopic biopsy is required. So an invasive test of biopsy may be required only if lining of uterus is thick. Please know that had you had pre-existing uterine cancer, you would have had bleeding earlier too. Simple tests can rule it out. Since corticosteroids can cause PMB without there being cancer, relax till you consult with your doctor. I hope this answers your query. Take care.