Postmenopausal bleeding

Postmenopausal bleeding is not a disease but a clinical symptom. With the continuous improvement of people's lives, women's life expectancy has gradually extended. One-third of the time in life should be spent after menopause. A series of geriatric diseases followed, and bleeding after menopause is one of the most common symptoms. Postmenopausal bleeding refers to vaginal bleeding that occurs 1 year after menstruation has stopped. It mainly refers to symptoms caused by non-organic, benign, and malignant lesions of the internal genitalia. The cause of postmenopausal bleeding should be found. With the development of medical science and the popularization of medical knowledge, people have become more alert to postmenopausal bleeding, and the proportion of postmenopausal bleeding caused by malignant lesions has gradually decreased. Less than 10% have been reported abroad. It is mainly caused by non-organic lesions, followed by benign lesions. Domestic reports vary, about 20% to 50%. In the pathological analysis of 1135 postmenopausal bleeding, non-organic lesions accounted for 34.3%, benign lesions accounted for 43.3%, and malignant tumors accounted for 22.4%. Postmenopausal bleeding mostly occurred within 5 years of menopause, accounting for 40.9%; the longer the bleeding from menopause, the older the age, the significantly increased the proportion of bleeding caused by malignant tumors. For those younger than 60 years old, vaginal bleeding caused by non-organic lesions accounted for 33.2%, and malignant tumors accounted for 16.7%; for those over 60 years old, the former accounted for 23.2%, the latter accounted for 33.6%, and the bleeding caused by malignant tumors doubled . For patients under 10 years of menopause, malignant tumors accounted for 15.5%, and for patients older than 10 years, the incidence of malignant tumors increased to 34.7%. For menopause older than 20 years, almost half of postmenopausal bleeding is caused by malignant tumors. The duration, amount, and frequency of vaginal bleeding are related to the etiology; functional lesions bleed for an average of 9 days, the amount of bleeding is small, the bleeding is 1 to 2 times, and the interval is long. The average bleeding time of benign lesions was 24.7 days, and the average bleeding time of malignant lesions was 152 days. The amount of bleeding was frequent, the frequency was frequent, and the interval was short. In short, the older the age, the longer the menopause, the more bleeding time and volume, the greater the likelihood of malignancy. Among bleeding caused by malignant tumors, the incidence of endometrial cancer (54.3%) was significantly higher than that of cervical cancer (36.9%), and that of ovarian cancer was 12.2%. There are reports in China that the incidence of cervical cancer is similar to that of uterine body cancer, and that the former is higher than the latter. Postmenopausal estrogen replacement therapy can also occur vaginal bleeding, with the general application of hormone replacement therapy, such bleeding will gradually increase. Patients with breast cancer should be treated with tamoxifen after surgery. Because of its weak estrogen effect, it can also cause postmenopausal bleeding.

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