Bleeding in Urine After Menopause? You Won't Believe What Your Doctor Might Find!

Dear Dr. Roach: A reader recently wrote in with a concerning symptom - bleeding while urinating. This is a rare and alarming occurrence, especially for women who have gone through menopause. The reader in question experienced this symptom for the first time in over three decades since menopause, prompting a visit to the gynecologist.

An ultrasound was performed to investigate the cause of the bleeding. The results showed a mildly thickened endometrium, which is the inner lining of the uterus, measuring 6.1 mm. Additionally, there were scattered cystic changes present. However, the ultrasound did not reveal any focal lesions or abnormalities that could be pinpointed as the cause of the bleeding.

Based on these findings, the gynecologist is recommending an endometrial biopsy for the patient. An endometrial biopsy is a medical procedure that involves taking a sample of tissue from the endometrium for further examination. This is usually done to investigate abnormal uterine bleeding, such as in this case, to rule out any underlying conditions that may require medical attention.

It is essential for women to seek medical attention if they experience bleeding after menopause. Postmenopausal bleeding, as it is known, can be a symptom of various underlying conditions, some of which may be serious. Some possible causes of postmenopausal bleeding include hormonal changes, vaginal dryness, infection, or in rare cases, cancer of the uterus or cervix.

The mild thickening of the endometrium, as seen in the ultrasound results, is a potential cause for concern. The normal thickness of the endometrium varies throughout a woman's menstrual cycle and with age. However, a thickness of 6.1 mm in a postmenopausal woman is considered abnormal and warrants further investigation.

The presence of scattered cystic changes also raises some suspicion. Cystic changes in the endometrium can be a normal finding in some cases, but in postmenopausal women, it may be associated with an increased risk of endometrial cancer or other underlying conditions.

While the ultrasound did not reveal any focal lesions, the endometrial biopsy recommended by the gynecologist will help to rule out any precancerous or cancerous changes in the endometrium. Additionally, the biopsy will help to determine if there are any other conditions, such as endometrial polyps or hyperplasia, that may be causing the bleeding and thickening of the endometrium.

It is reassuring that the reader acted promptly in seeking medical attention, and it is essential to follow through with the recommended endometrial biopsy to determine the cause of the bleeding. It is also crucial to note that any woman who experiences bleeding after menopause should seek medical attention, as it is always better to err on the side of caution when it comes to reproductive health.