Postmenopausal bleeding is an episode of bleeding 12 months or more after the last menstrual period. It is one of the most common reasons for referral to the gynecology department.All women with postmenopausal bleeding should be referred urgently; endometrial cancer is present in approximately10% of cases.
Causes
The majority of cases have benign cause. Other causes are
Non gynecological cause includes trauma or a bleeding disorder.
Use of hormonal replacement therapy
Vaginal atrophy
Endometrial hyperplasia
Endometrial carcinoma
Endometrial polyp
Carcinoma of cervix
Ovarian carcinoma
Carcinoma of vulva
Diagnosis
All women who have an episode of PMB should be seen under the two week referral rule. Endometrial cancer should be excluded.
Ultrasound scan and endometrial biopsy are complementary.Ultrasound scan can define endometrial thickness and identify structural abnormality of the uterus, endometrium and ovaries. Endometrial biopsy provides a histological diagnosis.
If the examination is normal, the bleeding has stopped and the endometrial thickness is <5mm on TUS, no further action need to be taken
Tran's vaginal ultrasound scan
TVUS can reliably asses the thickness of the endometrium and identify structural abnormalities such as polyps or sub mucous fibroid. A recent meta-analysis suggested that a cut off of 5mm was a reasonable compromise.It is important to remember that no endometrial thickness completely excludes cancer and the disease can present in women without PMB. Mr. Mukesh Bhatia provides Post-menopausal bleeding treatment in Ayurveda at ayurvedicconsult.
Endometrial biopsy
It is an effective screening test for endometrial cancer but miss's benign structural abnormalities such as endometrial polyps. All blind sampling of the endometrium will miss some cancer
Further investigations
Hysteroscopy
Curettage
Management
Benign condition
Vaginal atrophy can be treated using topical estrogens; where there is minimal systemic absorption. The preferred approach is to use vaginal estrogen daily for two weeks and then once or twice weekly for maintenance. This can be continued for a long time without the need for any monitoring. If other menopausal symptoms are present then HRT can be used.
Cervical polyp can be removed as an outpatient procedure. Sponge forceps are used to twist the pedicle gradually until the polyp comes away. Endometrial polyp should be removed at the time of hysteroscopy.
Endometrial hyperplasia without atypia has a good response rate when treated with progestrones.
Complex endometrial hyperplasia may progress to cancer
Herbal treatment in India at Bhatia Ayurveda for post-menopausal bleeding.
ASHOK CHAAL
ASHWANDHA ROOT
YASHTIMADHU ROOT
GUDUCHI PANCHANG
ANANTMUL NOOL
DASHMUL
JATAMANSI MOOL
KHADIR CHAL
BHRINGRAJ PANCHANG
RASNA MOOL
VACHA MOOL
TRIFALA
DEVDARU
VAT CHAAL
CHANDAN HARDWOOD
LODHRA CHAL
BALA MOOL
TAGAR MOOL
JAMBU CHAAL
HIRABOL EXUDATE
SHALMALI
Preparation made by this combination can be useful in post-menopausal bleeding.
Treatment of endometrial carcinoma
Treatment of endometrial carcinoma is hysterectomy and treatment is determined by the stage of cancer.
Stage1-hysterectomy and bilateral salpingo-oophorectomy.
Stage2-high risk stage 1 cancer requires lymph node dissection.
In case of carcinoma you can have a cup of Fagonia cretica tea daily Ayurvedic herbs treatment is at your door step just contact
Drmukeshbhatia18@ gmail.com
Free Ayurvedic consultation is available
Causes
The majority of cases have benign cause. Other causes are
Non gynecological cause includes trauma or a bleeding disorder.
Use of hormonal replacement therapy
Vaginal atrophy
Endometrial hyperplasia
Endometrial carcinoma
Endometrial polyp
Carcinoma of cervix
Ovarian carcinoma
Carcinoma of vulva
Diagnosis
All women who have an episode of PMB should be seen under the two week referral rule. Endometrial cancer should be excluded.
Ultrasound scan and endometrial biopsy are complementary.Ultrasound scan can define endometrial thickness and identify structural abnormality of the uterus, endometrium and ovaries. Endometrial biopsy provides a histological diagnosis.
If the examination is normal, the bleeding has stopped and the endometrial thickness is <5mm on TUS, no further action need to be taken
Tran's vaginal ultrasound scan
TVUS can reliably asses the thickness of the endometrium and identify structural abnormalities such as polyps or sub mucous fibroid. A recent meta-analysis suggested that a cut off of 5mm was a reasonable compromise.It is important to remember that no endometrial thickness completely excludes cancer and the disease can present in women without PMB. Mr. Mukesh Bhatia provides Post-menopausal bleeding treatment in Ayurveda at ayurvedicconsult.
Endometrial biopsy
It is an effective screening test for endometrial cancer but miss's benign structural abnormalities such as endometrial polyps. All blind sampling of the endometrium will miss some cancer
Further investigations
Hysteroscopy
Curettage
Management
Benign condition
Vaginal atrophy can be treated using topical estrogens; where there is minimal systemic absorption. The preferred approach is to use vaginal estrogen daily for two weeks and then once or twice weekly for maintenance. This can be continued for a long time without the need for any monitoring. If other menopausal symptoms are present then HRT can be used.
Cervical polyp can be removed as an outpatient procedure. Sponge forceps are used to twist the pedicle gradually until the polyp comes away. Endometrial polyp should be removed at the time of hysteroscopy.
Endometrial hyperplasia without atypia has a good response rate when treated with progestrones.
Complex endometrial hyperplasia may progress to cancer
Herbal treatment in India at Bhatia Ayurveda for post-menopausal bleeding.
ASHOK CHAAL
ASHWANDHA ROOT
YASHTIMADHU ROOT
GUDUCHI PANCHANG
ANANTMUL NOOL
DASHMUL
JATAMANSI MOOL
KHADIR CHAL
BHRINGRAJ PANCHANG
RASNA MOOL
VACHA MOOL
TRIFALA
DEVDARU
VAT CHAAL
CHANDAN HARDWOOD
LODHRA CHAL
BALA MOOL
TAGAR MOOL
JAMBU CHAAL
HIRABOL EXUDATE
SHALMALI
Preparation made by this combination can be useful in post-menopausal bleeding.
Treatment of endometrial carcinoma
Treatment of endometrial carcinoma is hysterectomy and treatment is determined by the stage of cancer.
Stage1-hysterectomy and bilateral salpingo-oophorectomy.
Stage2-high risk stage 1 cancer requires lymph node dissection.
In case of carcinoma you can have a cup of Fagonia cretica tea daily Ayurvedic herbs treatment is at your door step just contact
Drmukeshbhatia18@ gmail.com
Free Ayurvedic consultation is available
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