Is Postmenopausal Bleeding Important? Could It Be a Sign of Uterine Cancer?

Postmenopausal bleeding can be an early sign of uterine cancer. Therefore, even minimal postmenopausal bleeding should be taken seriously and thoroughly investigated.

Menopause is defined as the absence of menstrual periods for one year, typically occurring in women in their fifties. However, the menopausal process can manifest differently in each woman. Some women may experience reduced menstrual flow, shorter periods, or irregular cycles every few months before reaching full menopause. It is crucial to accurately diagnose menopause during this transition phase.

Postmenopausal vaginal bleeding must always be examined, as 10-15% of these cases are linked to uterine cancer. Other possible causes include endometrial thickening, unregulated estrogen use, and endometrial polyps. Additionally, in some cases, the bleeding may originate from the rectum or bladder rather than the vagina. Conditions such as hemorrhoids, rare instances of colon cancer, bladder disorders, or urinary stones can also lead to genital bleeding.

For patients presenting with postmenopausal bleeding, a detailed medical history is taken first. Factors like blood-thinning medications can contribute to bleeding. A comprehensive gynecological examination is then conducted. Ultrasound imaging is highly effective in evaluating the uterus and surrounding tissues, allowing for a detailed assessment of the endometrial lining, uterine wall, ovaries, and adjacent structures.

Generally, after examination and ultrasound, a biopsy is taken from the endometrial lining to confirm the diagnosis. In most cases, this procedure is performed in a clinical setting under local anesthesia without causing pain. Studies have shown that biopsies taken under local anesthesia in outpatient settings provide results as reliable as those obtained through curettage under general anesthesia. However, if cervical stenosis or an inadequate biopsy occurs, curettage under anesthesia may be necessary.

Procedures performed under anesthesia are usually considered outpatient surgeries, allowing patients to be discharged the same day. In some cases, hysteroscopy—a procedure using a camera to examine the uterus—is performed before taking a biopsy. This method enables direct visualization of the uterine lining, facilitating targeted biopsies and necessary interventions.

Following the biopsy, appropriate treatment plans are determined based on pathological results. Since uterine cancers often manifest with postmenopausal bleeding, early detection allows for successful treatment, often with a simple hysterectomy. Given that uterine cancer is the most common female genital tumor in both our country and developed nations, the significance of postmenopausal bleeding cannot be overstated.

Therefore, women experiencing postmenopausal bleeding should seek medical attention without delay. A simple examination and biopsy can identify the underlying cause, leading to timely and effective treatment. It is crucial for all women to attend regular check-ups and undergo screening tests as recommended for their health and well-being. Wishing you all a healthy and happy life.