Causes of postmenopausal bleeding include all of the following EXCEPT:
Correct Answer: Endometriosis
Description: Ans. c (Endometriosis). (Ref. Shaw, Gync, 13th ed., p 441)POSTMENOPAUSAL BLEEDING# Definition: Postmenopausal bleeding is bleeding from the reproductive system that occurs six months or more after menstrual periods have stopped due to menopause.# Causes:- Hormone replacements- Endometrial hyperplasia- Endometrial cancer- Endometrial polyps- Cervical cancer- Cervical lesions- Uterine tumors- Ovarian cancer- Estrogen-secreting tumors in other parts of the body- The most common cause of postmenopausal bleeding is HRT.# The estrogen in the replacement therapy ceases the symptoms of menopause (like hot flushes), and decreases the risk of osteoporosis. Sometimes this supplemental estrogen stimulates the uterine lining to grow. When the lining is shed, postmenopausal bleeding occurs. Most women on HRT usually take the hormone progesterone with the estrogen, and may have monthly withdrawal bleeding. This is a normal side-effect.MENORRHAGIA# Menorrhagia is defined quantitatively as a loss of >80 cc of blood per cycle, based on blood loss required to produce iron-deficiency anemia.# Predictors of menorrhagia include bleeding resulting in iron-deficiency anemia or a need for blood transfusion, excessive pad or tampon use, menses lasting longer than 8 days, passage of clots, bleeding through protection, or flooding at night.
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Gynaecology & Obstetrics
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