[Sportschosun Jang Jong-ho] A woman's menstrual cycle is one of the key indicators of her overall health. It usually follows a regular cycle, duration, and amount of bleeding. But if the bleeding looks different from usual, it should not be dismissed as a simple change in menstruation. It may signal an underlying condition.
Abnormal genital bleeding has different causes and meanings depending on age. Before puberty, it can be caused by abnormal estrogen stimulation, infection, tumors of the lower genital tract, ovarian tumors, foreign bodies, or trauma. If the cause of trauma is unclear, the possibility of physical abuse should also be considered.
In newborn girls, a small amount of vaginal bleeding may occur temporarily after birth as maternal estrogen levels drop. This is a physiological phenomenon that usually disappears naturally within two weeks after birth and does not require special treatment.
In women of reproductive age, abnormal bleeding is usually caused by the uterus. Common causes include endometrial polyps, adenomyosis, uterine fibroids, endometrial hyperplasia, and endometrial cancer. Systemic factors such as blood clotting disorders, ovulation problems, and medication use can also lead to abnormal uterine bleeding.
If bleeding recurs or becomes heavier than usual, it should not be ignored as a simple menstrual irregularity. In particular, if the amount of bleeding increases sharply or is accompanied by symptoms of anemia, an accurate diagnosis is needed.
To identify the cause, doctors perform tests such as ultrasound and endometrial biopsy, then determine the treatment based on the results. If a systemic cause is found, treatment is directed at the underlying disease. If a uterine condition is responsible, treatment may include hormone therapy, insertion of an intrauterine device, hysteroscopic surgery, or polyp removal.
For women aged 35 or older who develop abnormal uterine bleeding, an endometrial biopsy is recommended to check for endometrial cancer.
Bleeding after menopause requires even greater attention. Since normal menstruation does not occur after menopause, even a small amount of bleeding must be evaluated. Postmenopausal bleeding is common, affecting about 10% of women, but in some cases it may reveal endometrial cancer.
Benign conditions such as vaginal atrophy, cervical polyps, endometrial polyps, and endometrial hyperplasia are often the cause. However, malignant diseases such as endometrial cancer, cervical cancer, and hormone-producing ovarian tumors cannot be ruled out.
Doctors should also check whether the patient is taking hormone medications, tamoxifen, or anticoagulants. An accurate diagnosis is made through ultrasound and endometrial biopsy.
Kwon Bo-yong, head of gynecology at Davos Hospital, said, "Many women think abnormal bleeding is just a temporary hormonal change and delay seeing a doctor." She added, "But abnormal genital bleeding can be an early sign not only of benign conditions such as uterine fibroids or endometrial polyps, but also of serious diseases such as endometrial cancer, so accurate screening is important." She advised, "In particular, postmenopausal bleeding or repeated abnormal uterine bleeding after age 35 should always be evaluated by a gynecologist to find the cause. Early diagnosis and proper treatment are the best ways to protect women's health."
Jang Jong-ho, bellho@sportschosun.com
