[51F] Post-menopausal vaginal bleeding with family history of BRCA-related cancer

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

• Postmenopausal Bleeding: Any bleeding after menopause is considered abnormal and should be evaluated by a healthcare provider. This can be due to various reasons, including hormonal imbalances, endometrial atrophy (thinning of the lining of the uterus), or more serious conditions like endometrial hyperplasia (thickening of the uterine lining) or cancer.

• Endometrial Cancer: Given your history of precancerous cells and your family history of BRCA1/BRCA2 gene mutations, endometrial cancer is a concern. This type of cancer affects the lining of the uterus and can cause postmenopausal bleeding. An endometrial biopsy or ultrasound is typically used to diagnose this condition.

• Hormonal Imbalances: Even though you are not on hormone therapy, hormonal imbalances can still occur and cause unexpected bleeding. This is less likely given your history, but it is still a possibility.

• Other Gynecological Conditions: Conditions such as polyps or fibroids can also cause postmenopausal bleeding. These are generally benign but should be evaluated by a healthcare provider.

What you can do

1. Consult a Healthcare Provider: It is crucial to see a healthcare provider as soon as possible to evaluate the cause of your bleeding. They may recommend an ultrasound, endometrial biopsy, or other diagnostic tests to determine the cause.

2. Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and share longitudinal medical notes with your provider. This can help in providing a comprehensive view of your condition.

3. Stay Hydrated and Rest: While waiting for your appointment, make sure to stay hydrated and get plenty of rest.

4. Avoid Self-Medication: Do not take any over-the-counter medications to stop the bleeding without consulting your healthcare provider.

What you should look out for

• Increased Bleeding: If the bleeding becomes significantly heavier or you experience severe pain, seek immediate medical attention.

• Additional Symptoms: If you develop new symptoms such as fever, severe abdominal pain, or unusual discharge, contact your healthcare provider immediately.

• Family History: Given your family history of BRCA1/BRCA2 gene mutations, consider discussing genetic counseling and testing with your healthcare provider, even though it may be expensive. Some programs and grants may help cover the cost.

Remember, while I can provide information and suggestions, I am not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.