What are the causes of postmenopausal (post-menopause) vaginal bleeding?

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Differential Diagnosis for Vaginal Bleeding Post 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, which can be caused by estrogen replacement therapy or obesity.
  • Endometrial Polyps: Growths in the lining of the uterus that can cause bleeding.
  • Uterine Fibroids: Non-cancerous growths in the uterus that can cause bleeding, although they are less common post-menopause.
  • Hormone Replacement Therapy (HRT): Bleeding can occur as a side effect of HRT, especially in the first year of treatment.

Do Not Miss Diagnoses

  • Endometrial Cancer: A type of cancer that begins in the uterus and can cause postmenopausal bleeding. It is crucial to rule out this diagnosis due to its potential severity.
  • Cervical Cancer: Although less common, cervical cancer can also cause postmenopausal bleeding and must be considered to ensure timely treatment.
  • Ovarian Cancer: Bleeding can be a symptom of ovarian cancer, especially if it has spread to the uterus or vagina.

Rare Diagnoses

  • Vaginal Cancer: A rare type of cancer that can cause bleeding.
  • Uterine Sarcoma: A rare and aggressive type of cancer that begins in the muscle and supporting tissues of the uterine walls.
  • Metastatic Cancer: Cancer that has spread to the vagina or uterus from another part of the body, which can cause bleeding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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