Q. Which is the best treatment option for postmenopausal vaginal discharge?

Answered by
Dr. Sunil Jagdish Yadav
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 28, 2017 and last reviewed on: Sep 14, 2021

Hello doctor,

I am a 52 years old female, who weighs 75 kg, and I am 152 cm tall. I have postmenopausal vaginal discharge with a fair amount of red spots. What could be the cause? I had my menopause 1.5 years back, and I have type 2 diabetes, hypothyroidism, and asymptomatic cholelithiasis from last 15 years. After consulting many experts, we got three views, first is to carry out a biopsy and D and C, in the absence of malignant cancer, then we do not need to opt for hysterectomy (even with the endometrial thickness of 9 mm). Second, is to remove the uterus and the cervix, but keep the ovaries, as ovaries still produce 20 to 30% of the required hormones even after menopause. Third, is to remove the uterus and ovaries altogether and carry out the biopsy through frozen section at the time of TLH. Which is the best option, and why? What happens to hormone productions (even if it is 20 to 30%) after removal of ovaries? If ovaries are removed, do we have to get HRT? I have enclosed an ultrasound of the lower abdomen, transvaginal ultrasound, pap smear, MRI of the pelvis, and blood reports.



Welcome to

I have seen all the reports (attachment removed to protect patient identity).

First, D and C (dilation and curettage) with cervical biopsy with acetic acid or Lugol's iodine should be done as you have postmenopausal spotting with thickened endometrium of 9 mm, with associated risk factor that is diabetes. This is required to rule out malignancy.

Also, an antibiotic course should be given. Once this test is normal, then serial ultrasound every three months can be done to check for the endometrium thickness. Or if symptoms continue then you can opt for a hysterectomy.

Removal of ovaries after menopause can be done as hormone reduces significantly, the only problem with that may be postmenopausal symptoms like hot flushes, recurrent vaginitis, and osteoporosis, which we can deal symptomatically.

For more information consult an obstetrician and gynaecologist online -->

Thank you doctor,

Will an ultrasound be able to monitor the endometrial lining thickness accurately, or do we have to go for an MRI? Will D and C remove the existing thick lining? Will there be a chance of fibroid hemorrhage during D and C?



Welcome back to

  • See D and C is not a therapeutic procedure, but it is a diagnostic procedure. In your case, D and C is to rule out the cause of postmenopausal spotting.

Do not do a lot of web research, just consult your local gynecologist and proceed.

For further queries consult an obstetrician and gynaecologist online -->

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Why is my mother having periods after menopause?

Have complete blood count, thyroid function test, transvaginal scan, endometrial biopsy, local outpatients hysteroscopic examination to exclude local cause of bleeding like an endometrial or cerv...   Read full

When I went for uterus examination, why did the nurse question about cancer medication?

Also, postmenopausal bleeding has multiple causes like polyps, endometrial hyperplasia, etc ... I went for uterus examination today, and the nurse asked me if I had taken any cancer medication in...   Read full

I have multiple fibroid in uterus and missed my period for 70 days after medication. Why?

The only disadvantage is that endometrial hyperplasia ensues which could become atypical and malignant changes may occur ... Hence, therapy should be not more than three months and endometrial bi...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

Monkeypox Virus - Symptoms, Diagnosis, Treatment, Complications, and Prevention
Monkeypox is a zoonotic viral disease. This virus got its name as it was first noticed in laboratory monkeys in the late...  Read more»
Tomato Fever - Causes, Symptoms, Diagnosis, Treatment, and Prevention
Tomato fever is an unidentified and fast-spreading type of viral infection seen in young children. Scroll down to know m...  Read more»
Histrionic Personality Disorder - Causes, Signs, Symptoms, Diagnosis and Treatment
Histrionic personality disorder causes variations in the thinking ability of a person. Read this article to know more.  Read more»

Ask your health query to a doctor online?

Ask an Obstetrician & Gynaecologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.