What Counts as Post‑Menopausal Bleeding?
Postmenopausal bleeding (PMB) refers to any vaginal bleeding that occurs after 12 consecutive months without a period, marking the official onset of menopause. It can appear as:
- Spotting
- Light or heavy bleeding
- Pink, red, or brown discharge
While some causes are benign, postmenopausal bleeding is considered abnormal and should always be investigated. In 10% or more of cases, it may signal endometrial (uterine) cancer or a precancerous condition.
If you experience PMB, it’s crucial to consult a qualified expert for a complete evaluation. Dr. Deepti Asthana, Additional Director of Obstetrics & Gynecology at Fortis Gurgaon and founder of Kalosa Clinic, is widely regarded as the best gynecologist in Gurgaon, offering advanced diagnostic and therapeutic solutions for women from Gurgaon, Pataudi, Rewari, and surrounding regions.
Common Causes of Postmenopausal Bleeding
While not all bleeding after menopause is dangerous, identifying the root cause is critical for timely treatment. The most frequent causes include:
1. Endometrial Atrophy
Due to lower estrogen levels, the endometrial (uterine) lining becomes thin and fragile, leading to spotting or light bleeding.
2. Endometrial Hyperplasia
This is the abnormal thickening of the uterine lining, often due to unopposed estrogen stimulation. It may or may not involve cellular changes (atypia), which can increase the risk of endometrial cancer.
3. Polyps
Uterine or cervical polyps are usually benign but can cause irregular bleeding.
4. Hormone Replacement Therapy (HRT)
If you’re on HRT, especially estrogen-only or sequential regimens, irregular bleeding may occur as a side effect.
5. Vaginal or Cervical Atrophy
Thinning of vaginal and cervical tissues can lead to bleeding after intercourse or pelvic exams.
Endometrial Hyperplasia or Cancer Risk
Among all causes, endometrial hyperplasia with atypia and endometrial carcinoma are the most concerning. Women who are obese, diabetic, or have PCOS, hypertension, or a history of infertility are at higher risk.
Warning signs that may indicate a serious condition include:
- Recurrent bleeding
- Heavy flow instead of spotting
- Bleeding that starts after years of menopause
- Accompanying pelvic pain or bloating
This is why endometrial lining evaluation in Gurgaon becomes critical in such cases. It helps rule out or confirm malignancy and guides treatment.
Diagnostic Tests for Postmenopausal Bleeding
The goal of diagnosis is to determine the cause of bleeding and rule out endometrial cancer.
Transvaginal Ultrasound (TVS)
This is often the first step. It measures the endometrial thickness. In postmenopausal women:
- Endometrial thickness <4mm is typically considered safe
- 4mm may require further evaluation via biopsy or hysteroscopy
Pap Smear
Helps detect cervical dysplasia or cancer but does not assess the uterine lining.
Blood Tests
To assess thyroid function, clotting profile, and hormone levels if needed.
Hysteroscopy and Biopsy: Gold Standard for Evaluation
If ultrasound findings are suspicious or inconclusive, your gynecologist may recommend:
Hysteroscopy
A thin, lighted tube (hysteroscope) is inserted through the cervix into the uterus to visualize the lining in real-time. It can identify:
- Polyps
- Abnormal tissue
- Irregular bleeding sources
Endometrial Biopsy
A small sample of the uterine lining is taken and sent for histopathology to check for:
- Hyperplasia
- Atypical cells
- Malignancy
These tests are routinely performed by Dr. Deepti Asthana at Fortis Gurgaon and Kalosa Clinic, where advanced hysteroscopic equipment ensures accurate diagnosis with minimal discomfort.
Treatment Options for Postmenopausal Bleeding
Treatment depends entirely on the underlying cause. Here are common scenarios and how they are addressed:
1. Atrophic Vaginitis / Endometrial Atrophy
- Topical estrogen creams or tablets
- Vaginal moisturizers
- Lifestyle changes
2. Endometrial Polyps
- Hysteroscopic polypectomy (removal during hysteroscopy)
- Often done as an outpatient procedure
3. Endometrial Hyperplasia
- Without atypia: Treated with progesterone therapy (oral or IUD)
- With atypia: Requires close follow-up or hysterectomy if fertility is not a concern
4. Endometrial Cancer
If biopsy confirms cancer:
- Laparoscopic hysterectomy is the standard of care
- May include removal of ovaries and lymph nodes depending on stage
- Followed by radiation or chemotherapy if needed
5. Hormone Therapy-Related Bleeding
- Adjusting or discontinuing hormone therapy under expert supervision
Why Choose Dr. Deepti Asthana for Postmenopausal Bleeding Care in Gurgaon?
- Additional Director, Obstetrics & Gynecology at Fortis Gurgaon
- Expert in complex diagnostics including endometrial lining evaluation in Gurgaon
- Advanced hysteroscopy and laparoscopy specialist
- Trusted by patients from Gurgaon, Pataudi, Jhajjar, Rewari, Bhiwadi, and South Delhi
- Offers personalized, ethical, and minimally invasive care
Dr. Asthana’s approach combines cutting-edge diagnostics with compassionate care. Women with postmenopausal bleeding are given priority diagnostic appointments and personalized treatment plans based on age, health, and future goals.
Real Patient Testimonials
Anjali R., 56 – Pataudi
“I started spotting years after menopause and didn’t know how serious it could be. I’m so glad I found Dr. Deepti Asthana. Her approach was calm and reassuring. She performed a hysteroscopy and biopsy and thankfully, it wasn’t cancer. She treated my condition with medication, and I’ve been fine ever since.”
Meena S., 61 – Gurgaon Sector 57
“After some bleeding post-menopause, I panicked. Dr. Asthana was recommended by my daughter. She took one look at my ultrasound and ordered a biopsy. The early diagnosis helped prevent cancer. I’m so thankful for her clear communication and surgical expertise.”
Frequently Asked Questions (FAQs)
1. Is bleeding after menopause always cancer?
No, but it should never be ignored. While only 10–15% of cases turn out to be cancerous, early evaluation is crucial for peace of mind and timely treatment.
2. What is the normal endometrial thickness in a postmenopausal woman?
Less than 4 mm. Anything more may need further evaluation with a biopsy or hysteroscopy.
3. Is hysteroscopy painful?
It is a minimally invasive, short procedure. It is done with local or short general anesthesia and causes minimal discomfort.
4. Will I need surgery if I have postmenopausal bleeding?
Not always. Surgery is recommended only when necessary—especially in cases of cancer, atypical hyperplasia, or large polyps.
5. How long does the evaluation process take?
Most diagnostic tests can be completed within 1–2 visits. Treatment options are usually started within a week based on results.
Book Your Evaluation Now
Don’t ignore postmenopausal bleeding. Whether you live in Pataudi, Old Gurgaon, Manesar, or nearby areas, early diagnosis is key to peace of mind and health preservation.
Consult Dr. Deepti Asthana, Additional Director at Fortis Gurgaon, for expert evaluation of the endometrial lining, hysteroscopic diagnosis, and personalized care plans. Book Your Appointment Here
Call:+91 98188 21675
Clinics: Fortis Hospital Gurgaon & Kalosa Clinic near Huda City Center
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