Menopause is diagnosed in hindsight after having no periods for 12 months. The blood tests can sometimes be misleading. If this is your first period in 12 months, then you have postmenopausal bleeding. Postmenopausal bleeding should be looked at promptly. The most common cause is an atrophic endometrium (thin endometrium lacking oestrogen). But the most important diagnosis to rule out is a precancerous or a cancerous lesion of the lining of the uterus (the endometrium). In our profession, we say that postmenopausal bleeding is cancer until proven otherwise.
If you are still menstruating irregularly and are perimenopausal, a heavy period is abnormal and also requires urgent attention. The normal thickness of the endometrium in a postmenopausal woman is 4-5 mm. 24 mm is quite thickened and you would definitely need to rule out endometrial cancer. Most studies suggest that an endometrial thickness above 20 mm is a sinister sign.
That being said, you would be categorized as category 1 and would be deemed as an urgent appointment (usually within 4 weeks). You can certainly seek an earlier appointment or seek another specialist who may be able to see you sooner. The investigation that you would require is an endometrial biopsy. This can be obtained in the clinic at your first consultation with a Pipelle device. This is a thin long tube that is inserted into the uterus through the cervix and a biopsy is obtained. The gold standard procedure is a Hysteroscopy D and C to visualize the lining of the uterus and obtain a decent sample for histology.
Report this post
You must be a HealthShare member to report this post.
to your account or
now (it's free).