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Tamoxifen increases the risk of postmenopausal bleeding, endometrial polyps, hyperplasia, and endometrial cancer; using tamoxifen with an intrauterine system releasing levonorgestrel might increase vaginal bleeding after 1 to 2 years, but reduces somewhat endometrial polyps and hyperplasia, but not necessarily endometrial cancer. [27]
No definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen. [3] Risk factors include obesity, high blood pressure and a history of cervical polyps. [3] Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps.
Symptoms of uterine sarcoma include unusual vaginal bleeding or a mass in the vagina. [2] Risk factors for endometrial cancer include obesity, metabolic syndrome, type 2 diabetes, taking pills that contain estrogen without progesterone, a history of tamoxifen use, late menopause, and a family history of the condition.
Vulvar cancer can produce lumps that are red, pink or white, and may feel rough or thick to the touch, as a symptom, and vaginal cancer, while rare, can also cause a lump.
Vaginal bleeding or spotting in women after menopause occurs in 90% of endometrial cancer. [2] [13] [14] Bleeding is especially common with adenocarcinoma, occurring in two-thirds of all cases. [2] [10] Abnormal menstrual cycles or extremely long, heavy, or frequent episodes of bleeding in women before menopause may also be a sign of ...
Other types of cancer include cervical cancer; bleeding in that case can sometimes be triggered by postcoital bleeding. Cancers of the vagina or fallopian tubes are rare causes of hemorrhage. Uterine fibroids represent a common, benign condition that may lead to bleeding, specifically if the lesion affects the uterine cavity.
If the degree of bleeding is mild, all that may be sought is the reassurance that there is no sinister underlying cause. If anemia occurs due to bleeding then iron tablets may be used to help restore normal hemoglobin levels. [1] The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20]
The cause of the bleeding can often be discerned on the basis of the bleeding history, physical examination, and other medical tests as appropriate. The physical examination for evaluating vaginal bleeding typically includes visualization of the cervix with a speculum, a bimanual exam, and a rectovaginal exam. These are focused on finding the ...