postmenopausal bleeding
Introduction
Introduction There are many reasons for postmenopausal bleeding. There are many possibilities according to the bleeding site. Women don't have to be too scared. They should go to the hospital for examination and use the right medicine. Postmenopausal bleeding is divided into two major categories, benign and malignant. According to the bleeding site. Can be divided into vulva, vagina. Uterus, ovaries and fallopian tube hemorrhage. The key to this disease is early detection and early treatment. Once vaginal bleeding occurs, it should not be taken lightly. You should go to the hospital for diagnosis and take timely treatment. During vaginal bleeding, pay attention to personal hygiene and prevent infection, especially when the leucorrhea is already smelling.
Cause
Cause
Women enter menopause and menstruation does not come again. If vaginal bleeding occurs after more than 1 year of menopause, it is often an early sign of disease. Postmenopausal vaginal bleeding, the most common sites are vulva, vagina and uterus. The most common of these is uterine bleeding, and it is also the most complicated. After the extinction, vaginal bleeding is benign and malignant. More common benign diseases include senile vaginitis, endometritis, cervical polyps, endometrial polyps, uterine stroke syndrome, and postmenopausal IUDs. More common malignant diseases include endometrial cancer, cervical cancer, ovarian cancer, and fallopian tube cancer. Among them, endometrial cancer accounts for about 80% of postmenopausal bleeding.
Examine
an examination
Related inspection
Luteinizing hormone LH vaginal biopsy electronic colposcopy vaginal bleeding examination
Women generally after the age of 50, menstruation for more than one year of menopause is called menopause. Vaginal bleeding after menopause, called postmenopausal bleeding. Postmenopausal bleeding is generally caused by the following causes.
Postmenopausal bleeding caused by vaginal and cervical factors, through detailed medical history, gynecological examination, cervical cytology and histological examination, it is generally not difficult to make a definitive diagnosis. Causes of bleeding caused by uterine factors, benign lesions such as endometrial atrophy, endometritis, endometrial polyps, submucosal fibroids, endometrial hyperplasia and functional changes caused by hormone replacement therapy. Malignant lesions include endometrial cancer, uterine sarcoma and the like.
Postmenopausal bleeding caused by endogenous or exogenous estrogen. Postmenopausal decline in estrogen levels due to the gradual decline of ovarian physiological function can not support the effective growth of the endometrium, but the endometrium of postmenopausal women still respond to estrogen. Postmenopausal ovarian stroma and adrenal cortex can secrete androgen, androgen is converted to estrone. Therefore, estrogen can cause vaginal bleeding when it fluctuates. Similarly, the endometrium can also cause bleeding when it receives the action of foreign estrogen.
Malignant diseases: such as endometrial cancer, cervical adenocarcinoma, uterine sarcoma, ovarian malignant tumors, etc.
Bleeding caused by benign organic lesions: endometritis, intrauterine devices, submucosal uterine fibroids, benign ovarian tumors, cervical polyps, urethral meat, senile vaginitis.
Diagnosis
Differential diagnosis
Hysteroscopy: the diagnostic accuracy of fiber hysteroscopy is higher than that of TVS. TVS can miss local hyperplasia, adenocarcinoma. Even if the endometrium of TVS and SHSG is seen, it needs to be directly biopsy under hysteroscopy. Peri-menopausal and postmenopausal uterine bleeding lesions, fiber hysteroscopy is superior to vaginal ultrasound for four reasons: First, the double-layer endometrial thickness without hormone therapy is <4mm as the cut point, vaginal ultrasonography abnormal uterus The rate of missed diagnosis of endometrium is 5.5%, and the accuracy of fiberoptic hysteroscopic biopsy is higher than 94%. Second, the initial stage of endometrial hyperplasia and endometrial adenocarcinoma are focal, and vaginal ultrasound is easily missed. Fiberoptic laparoscopic can be seen and taken under direct vision. Third, sometimes to determine the extent of tumor or lesion extension, more than two biopsies are needed. Fiber hysteroscopy can be explored under direct vision and more Point biopsy, fourth, vaginal ultrasound abnormalities are found to be pathologically confirmed, fiber hysteroscopy can be directly used for biopsy.
