Hi,
There are many underlying causes of vaginal bleeding at this age. All women with postmenopausal bleeding should be referred urgently.
The peak incidence for
endometrial carcinoma is between 65 and 75 years of age.
Causes of postmenopausal bleeding include endometrial carcinoma; cervical carcinoma; vaginal atrophy;
endometrial hyperplasia +/- polyp; cervical polyps; hormone-producing ovarian tumors; haematuria and
rectal bleeding.
Abdominal and pelvic examinations should be carried out to look for masses.
Speculum examination should be performed to see if a source of bleeding can be identified, assess atrophic changes in the vagina and look for evidence of cervical malignancy or polyps.
Ultrasound scan and
endometrial biopsy are complementary. An ultrasound scan can define the endometrial thickness and identify structural abnormalities of the uterus, endometrium, and ovaries.
Endometrial biopsy provides a histological diagnosis. The measurement of endometrial thickness aims to identify which women with postmenopausal bleeding are at significant risk of
endometrial cancer.
If the examination is normal, the bleeding has stopped and the endometrial thickness is.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Naira Jahangir, OB and GYN Specialist