Brown Discharge After Menopause: Causes and Concerns

Brown discharge after menopause?

Hello, doctor.
In early November last year, I visited M Hospital due to brown discharge and lower abdominal pain.
Since I have no sexual experience, the doctor performed an abdominal ultrasound and a urinalysis, diagnosing me with a urinary tract infection.
I was informed that there were no abnormalities in the ovaries or uterus, and the endometrial thickness was only 0.41 cm.
I was prescribed antibiotics and related medications.
However, two weeks after starting the medication, I continued to experience intermittent brown discharge up to now.
During this period, I consulted another gynecologist who informed me that there was a polyp in the urethra and that my urinalysis showed traces of blood.
I was advised to see a urologist, and I did so.
The urologist also conducted ultrasound, X-rays, and bacterial cultures, finding no abnormalities in the urinary system.
I also applied the topical medication prescribed by the gynecologist, but I still experienced intermittent bleeding, which I am certain is vaginal bleeding.
Recently, I returned to M Hospital to see the original doctor, who personally performed another ultrasound and confirmed that there were no abnormalities in the ovaries or uterus.
Since, in addition to the bleeding, I have been experiencing soreness in my lower abdomen and lower back, I asked the doctor if it could be pelvic inflammatory disease.
The doctor replied that it was unlikely due to my lack of sexual experience and suggested that the bleeding could be caused by atrophy due to aging, advising me to monitor the situation.
Feeling quite lost, I would like to ask the doctor the following questions, hoping for your guidance.
Thank you!
1.
If it is atrophy, can intermittent bleeding last this long?
2.
Since I have no sexual experience and have not had a pelvic exam, could there be other issues that an abdominal ultrasound might not detect?
3.
Should I consider switching to another hospital for further evaluation? What tests should I undergo to determine the true cause of the bleeding? Thank you!

CY, 50~59 year old female. Ask Date: 2023/01/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, for individuals who have had sexual experience, doctors typically perform a pelvic examination to check for any issues with the cervix and may conduct an endometrial evaluation.
However, since you are unmarried and have no sexual experience, this presents a challenge.
It would be best for you to have a detailed discussion with your physician about the next steps in your care.
Wishing you good health.

Reply Date: 2023/01/14

More Info

Understanding brown discharge after menopause can be a complex issue, especially when accompanied by other symptoms such as abdominal pain. It is important to consider various factors that could contribute to this condition. Based on your description, it seems you have already undergone several evaluations, including ultrasounds and urine tests, which have not revealed any significant abnormalities in your reproductive organs. However, the persistent brown discharge and associated symptoms warrant further exploration.

1. Causes of Brown Discharge: Brown discharge after menopause can often be attributed to hormonal changes, particularly a decrease in estrogen levels, which can lead to thinning of the vaginal walls (atrophy). This atrophy can cause slight bleeding, which may appear brown due to the oxidation of blood. While this can be a common occurrence, the duration and persistence of your symptoms are concerning. It is not typical for atrophic bleeding to last for an extended period without resolution, so further investigation may be warranted.

2. Potential Issues Not Detected by Ultrasound: While ultrasounds are excellent for visualizing structural abnormalities in the reproductive organs, they may not detect all conditions. For example, conditions such as endometrial hyperplasia or polyps may not always be visible on an ultrasound, especially if they are small. Additionally, certain infections or inflammatory conditions may not be evident without a more invasive examination, such as a pelvic exam or hysteroscopy. Given your history of urinary issues and the presence of potential polyps, it may be beneficial to consider a referral to a gynecologist for a thorough evaluation.

3. Further Evaluation and Testing: If your symptoms persist, it may be appropriate to seek a second opinion or consult a specialist in gynecology. A pelvic exam could provide additional insights, and further tests such as a hysteroscopy (to visualize the inside of the uterus) or endometrial biopsy (to assess the uterine lining) could be considered. These procedures can help rule out conditions such as endometrial cancer, which, although less common, is a serious concern in postmenopausal women with abnormal bleeding.

4. When to Seek Immediate Care: If you experience severe pain, heavy bleeding, or any other alarming symptoms, it is crucial to seek immediate medical attention. These could be signs of a more serious condition that requires urgent intervention.

In summary, while hormonal changes due to menopause can lead to brown discharge, the persistence of your symptoms, along with abdominal pain, suggests that further evaluation is necessary. It is advisable to consult with a gynecologist who can perform a thorough examination and recommend appropriate tests to determine the underlying cause of your symptoms. Your health and peace of mind are paramount, and addressing these concerns with a specialist can help clarify the situation and guide you toward effective management.

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