[50F] Experiencing unusual post-menopausal bleeding and lightheadedness

Patient Description

A 50-year-old female has been experiencing continuous vaginal bleeding for 8 days, which began after receiving a Tnk shot for a stroke. Initially, the bleeding was heavy, requiring two pads an hour, but has now slowed to a pad every two hours. The bleeding is bright red, has a distinct smell, and is unusual for the patient, who has been in menopause with no period for 7 months prior. Accompanying symptoms include lightheadedness, especially when standing up quickly or riding in a car, and abdominal discomfort. The patient has a medical history of high blood pressure, COPD, asthma diagnosed at age 10, type 2 diabetes, and is in remission from breast cancer since 2003. Current medications include Metformin, Lisinopril, Albuterol, and Wellbutrin. The patient is allergic to oxytocin and fentanyl. Despite a visit to the ER where blood work was reported as good, the patient feels something is not right.

Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

Endometrial Hyperplasia or Polyps: These are conditions where the lining of the uterus thickens, often due to hormonal imbalances. This can cause heavy, prolonged menstrual bleeding, even in postmenopausal women.
- Treatment often involves hormonal therapy or surgical procedures.
Uterine Fibroids: These are noncancerous growths in the uterus that can cause heavy bleeding. They are common in women in their 40s and early 50s.
- Treatment can range from medication to manage symptoms to surgical removal of the fibroids.
Endometrial or Uterine Cancer: Although less likely, postmenopausal bleeding can be a sign of these cancers. Given your history of breast cancer, it's important not to overlook this possibility.
- Treatment typically involves surgery, radiation, chemotherapy, or hormonal therapy.
Bleeding Disorder: Conditions such as Von Willebrand disease or platelet function disorders can cause heavy or prolonged menstrual bleeding.
- Treatment typically involves medication to help blood clot more effectively.

Please note that these are possibilities based on the information provided and not a definitive diagnosis. Only a healthcare provider can provide a formal diagnosis.

What you can do

Given the severity and duration of your symptoms, it's important to seek immediate medical attention. Here are some steps you can take:

Go to the emergency department: Given the amount of bleeding you're experiencing and your feeling of lightheadedness, it's important to seek immediate medical help.
Keep track of your symptoms: Note down the severity and frequency of your bleeding, any associated symptoms, and any triggers that you notice. This information can be helpful for your healthcare provider.
Stay hydrated: Heavy bleeding can lead to dehydration. Make sure to drink plenty of fluids, especially water.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

Severe abdominal pain
Fainting or severe dizziness
An increase in the amount of bleeding
Shortness of breath or chest pain

Remember, while I strive to provide accurate information, I'm an AI and not a substitute for professional medical advice. Please consult with a healthcare provider for a formal diagnosis and treatment.

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9 mo ago

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