Differential Diagnosis for Bleeding after Menopause
Single Most Likely Diagnosis
- Atrophic Vaginitis: This is the most common cause of postmenopausal bleeding, resulting from the thinning and drying of the vaginal walls due to decreased estrogen levels.
Other Likely Diagnoses
- Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, often due to estrogen imbalance, which can lead to bleeding.
- Endometrial Polyps: Growths in the lining of the uterus that can cause irregular bleeding.
- Uterine Fibroids: Non-cancerous growths in the uterus that can lead to bleeding, although they are more common before menopause.
- Hormone Replacement Therapy (HRT): Bleeding can occur in women on HRT due to the hormonal effects.
Do Not Miss Diagnoses
- Endometrial Cancer: A serious condition that requires prompt diagnosis and treatment. Postmenopausal bleeding is a key symptom.
- Cervical Cancer: Although less common, cervical cancer can present with bleeding and must be ruled out.
- Ovarian Cancer: Can sometimes present with vaginal bleeding, among other symptoms.
Rare Diagnoses
- Sarcomas: Rare cancers that can occur in the uterus and present with bleeding.
- Vaginal Cancer: A rare type of cancer that can cause bleeding.
- Metastatic Cancer: Cancer that has spread to the vagina or uterus from another part of the body, which can cause bleeding.