Menopausal Periods

Women realize that after menopause women do not have periods. We technically run out of eggs to form the structures such as the follicle and corpus luteum which produce hormones and we are unable to ovulate or produce an egg at all. So there are no more cycles and at menopause women stop having these monthly bleeds called periods. But many of us have just come to call any bleeding episodes that act like periods and feel like periods: a period. It is true there might be that last fling ovulation or so. But then again, technically, that is not really menopause, but perimenopause. Your gyno will call this post-menopausal bleeding, and in the back of her mind, a bit of a red flag. She will want to know more. Statistics show that 10 to 15% of women who bleed  during menopause, when bleeding should have already stopped, will have lining cancer of the uterus. So investigations must be undertaken to make sure you don't have a treatable condition of the uterus that is causing bleeding. The tests that need to be done should include pelvic ultrasound, with or without 3-D ultrasound, endometrial biopsy, hysteroscopy, and/or dilatation and curettage. My favorite hysteroscope is the 3 mm flexible video hysteroscope that can be used in the office under local so that the patient can view the procedure should she choose to, but women in menopause often will have tightly closed cervical tissue that make the procedure, even with this tiny scope, more difficult. CT scans and MRIs are not usually used for primary diagnosis and blood testing isn't really helpful as a first line either. A piece of tissue under the microsope is what is important for that first step which is the diagnosis. And maybe you really are having, just a period!