Searchlight Logo
special_image

    • News
      • Front Page
      • News
      • Breaking News
      • Press Release
      • Features
      • Special Features
      • From the Courts
      • Sports
      • Regional / World
    • Opinions
      • Editorial
      • Our Readers’ Opinions
      • Bassy – Love Vine
      • Dr. Fraser- Point of View
      • R. Rose – Eye of the Needle
      • On Target
      • Dr Jozelle Miller
      • The World Around Us
      • Random Thoughts
    • Advice
      • Kitchen Corner
      • What’s on Fleek this week
      • Health Wise
      • Physician’s Weekly
      • Business Buzz
      • Hey Rosie!
      • Prime the pump
    • ePaper
    • Obituaries
      • In Memoriam / Acknowledgement
      • Tribute
    • Contact Us
      • Advertise With Us
      • Letters To The Editor
      • General Contact Information
      • Contact our Webmaster
    • About Us
      • Privacy Policy
      • Interactive Media Ltd
      • St. Vincent & the Grenadines
    • Subscribe
    • News
      • Front Page
      • News
      • Breaking News
      • Press Release
      • Features
      • Special Features
      • From the Courts
      • Sports
      • Regional / World
    • Opinions
      • Editorial
      • Our Readers’ Opinions
      • Bassy – Love Vine
      • Dr. Fraser- Point of View
      • R. Rose – Eye of the Needle
      • On Target
      • Dr Jozelle Miller
      • The World Around Us
      • Random Thoughts
    • Advice
      • Kitchen Corner
      • What’s on Fleek this week
      • Health Wise
      • Physician’s Weekly
      • Business Buzz
      • Hey Rosie!
      • Prime the pump
    • ePaper
    • Obituaries
      • In Memoriam / Acknowledgement
      • Tribute
    • Contact Us
      • Advertise With Us
      • Letters To The Editor
      • General Contact Information
      • Contact our Webmaster
    • About Us
      • Privacy Policy
      • Interactive Media Ltd
      • St. Vincent & the Grenadines
    • Subscribe
Postmenopausal bleeding
GYNAECOLOGY EXPLAINED
March 6, 2020

Postmenopausal bleeding

POSTMENOPAUSAL bleeding is bleeding occurring 1 year after menopause and has an incidence of 10 percent and a 10-15 percent risk of cancer, most endometrial cancers present with postmenopausal bleeding with the incidence being as high as 90 percent.

Bleeding can be due to many causes, but due to the risk of cancer should be investigated as soon as possible by a gynaecologist with an interest in Gynaecological oncology.

Causes are numerous and include: 1. The lining of the womb can be abnormally thickened, this is called endometrial hyperplasia and depending on how abnormal it is one can have an increased risk of cancer.

2. Endometrial polyps are a common cause of bleeding and can be associated with at least 40 percent of bleeding, most polyps are not cancerous, however some can be cancerous, in these instances blind biopsies might give a false reassurance, as a result it is recommended that these polyps be removed under direct vision by a procedure called hysteroscopy where a camera is placed in the womb, preferably in an outpatient setting.

3. Endometrial cancer is where the lining of the womb develops into a cancer and 90 percent of cancers present with bleeding.

4. Cervical causes include cervical cancer, cervical growths called polyps.

5. Vaginal causes commonly include a thinned vaginal tissue a condition called atrophic vaginitis where there is a lack of oestrogen and the vagina can be subject to being easily traumatised and bleed.

6. Vulval causes are rare and include vulval cancer.

On presentation a gynaecological history is taken, other factors noted like BMI are taken. The genitals are inspected, a speculum examination is done to rule out local causes like cervical lesions and thinning of the vaginal tissue.

An internal scan (Trans-vaginal ultrasound) is done to look at the uterus and ovaries, the lining of the womb should be thin, however if it is thickened equal to or over 4mm then a biopsy is to be performed.

If the lining of the womb is thickened the current gold standard is the patient to have an outpatient hysteroscopy (camera in the womb) and a directed biopsy. If a polyp is found, then it should be removed under direct vision, this is to make sure that it is completely removed, as some polyps can contain cancer.

If the endometrial lining is thin then the patient can be safely discharged, but should be informed that if the bleeding re-occurs they should be advised to come back again, on that presentation they would have a hysteroscopy and biopsy done, this is because rare forms of endometrial cancer can present with a thin endometrium.

If the biopsy is negative, then the patient is discharged, but should be given information that if it occurs then they should come back to be investigated again.

In summary post-menopausal bleeding is signifi cant as it can carry a risk of 10-15 percent risk of cancer and prompt investigation and management is needed to rule this out. Patients should be seen in speciality clinics by gynaecologists with an interest in Gynaecological Oncology to streamline care to offer patients the best management options and triaging, outpatient hysteroscopy is the gold standard for investigation of postmenopausal bleeding.

Dr John Barker Bsc MBBS MRCOG, Dip (Risk Management). Obstetrician/ Gynaecologist at Arnos Vale Medical Center, Consultant Obstetrician/ Gynaecologist UK He has completed the Advanced Training Skills Module in Gynaecological Oncology in the UK and runs gynaecological oncology clinics for diagnosis and management of suspected and confirmed female genital cancers.

  • FacebookComments
  • ALSO IN THE NEWS
    Domestic worker killed at Long Wall
    Front Page
    Domestic worker killed at Long Wall
    Webmaster 
    September 12, 2025
    FAMILY MEMBERS of a woman who was killed at Long Wall say they suspect their relative was hacked by a person they all know very well. On Tuesday, Sept...
    NDP never built a single house in SVG – Finance Minister
    Front Page
    NDP never built a single house in SVG – Finance Minister
    Webmaster 
    September 12, 2025
    THE IDEA THAT HOUSING is a right, that every Vincentian has a right to safe and secure housing, and that the government has a role to play in ensuring...
    No bail for Police officer charged with attempted murder
    Front Page
    No bail for Police officer charged with attempted murder
    Webmaster 
    September 12, 2025
    A POLICE OFFICER, who allegedly stabbed his ex-girlfriend 26 times about her body was remanded even as his lawyer argued that the Royal St Vincent and...
    New ULP Administration will roll out AI policy
    Front Page
    New ULP Administration will roll out AI policy
    Webmaster 
    September 12, 2025
    A NEW UNITY LABOUR PARTY ADMINISTRATION will be rolling out an Artificial Intelligence (AI) policy to embrace its positives and guard against the nega...
    Sandy Bay Secondary School marks 20th Anniversary
    Front Page
    Sandy Bay Secondary School marks 20th Anniversary
    Webmaster 
    September 12, 2025
    TUESDAY, SEPTEMBER, 9,2025 was a memorable day for the staff and students of the Sandy Bay Secondary School, which was marking its 20th anniversary wi...
    Foundation implements community driven project in SVG
    News
    Foundation implements community driven project in SVG
    Webmaster 
    September 12, 2025
    THE ASHLEY LASHLEY Foundation, with support from the United States Government, is implementing a local-level project entitled “Community-Driven Strate...
    News
    Foundation implements community driven project in SVG
    News
    Foundation implements community driven project in SVG
    Webmaster 
    September 12, 2025
    THE ASHLEY LASHLEY Foundation, with support from the United States Government, is implementing a local-level project entitled “Community-Driven Strate...
    Skills not available locally, non-nationals have to be hired says Finance Minister
    News
    Skills not available locally, non-nationals have to be hired says Finance Minister
    Webmaster 
    September 12, 2025
    NON- NATIONALS ARE being hired to fill several jobs in St Vincent and the Grenadines (SVG) simply because locals did not have the required skill sets....
    Montgomery Daniel squashes rumours that he’s sick
    News
    Montgomery Daniel squashes rumours that he’s sick
    Webmaster 
    September 12, 2025
    DEPUTY PRIME MINISTER Montgomery Daniel has sought to clear around rumours that have been circulating relating to his health. Speaking on NBC radio on...
    $1.3 billion in Tourism investment to yield 2,000 jobs – Camillo
    News
    $1.3 billion in Tourism investment to yield 2,000 jobs – Camillo
    Webmaster 
    September 12, 2025
    The GOVERNMENT of St Vincent and the Grenadines is set to sign agreements for tourism investment of $1.3 billion on mainland St.Vincent. On Monday, Se...
    Bagga’ man pleads guilty to illegal gun, ammo possession
    From the Courts, News
    Bagga’ man pleads guilty to illegal gun, ammo possession
    Webmaster 
    September 12, 2025
    A BARROUALLIE MAN will be sentenced next week after pleading guilty to being in illegal possession of a firearm and eight rounds of ammunition. Demron...

    E-EDITION
    ePaper
    google_play
    app_store
    Subscribe Now
    • Interactive Media Ltd. • P.O. Box 152 • Kingstown • St. Vincent and the Grenadines • Phone: 784-456-1558 © Copyright Interactive Media Ltd.. All rights reserved.
    We use cookies to ensure that we give you the best experience on our website. If you continue to use this site we will assume that you are happy with it.Ok