What causes gynecological bleeding in elderly women?

Generally, gynecological bleeding refers to vaginal bleeding. In elderly individuals, causes of vaginal bleeding may include fluctuations in estrogen levels, vaginal mucosal atrophy, senile vaginitis, endometritis, and endometrial polyps. It is recommended to seek timely medical evaluation to determine the underlying cause and receive appropriate treatment under the guidance of a healthcare professional. Specific analyses are as follows:

1. Estrogen Level Fluctuations

In certain situations—such as during hormone replacement therapy or while taking specific medications—fluctuations in estrogen levels may occur in older adults, potentially leading to light vaginal bleeding. Dosage or regimens for hormone replacement therapy should be adjusted according to medical advice.

2. Vaginal Mucosal Atrophy

With aging, the vaginal mucosa becomes thinner and loses elasticity, which may lead to vaginal atrophy. The mucosa becomes fragile and prone to injury and bleeding from friction. Using lubricants during sexual intercourse is recommended, and excessive vaginal cleaning should be avoided in daily life.

3. Senile Vaginitis

In elderly individuals, vaginal wall atrophy, thinning of the mucosa, and decreased local resistance make the vagina more susceptible to pathogenic microorganisms, resulting in senile vaginitis. Severe inflammation can cause congestion, edema, or even ulceration of the vaginal mucosa, leading to bloody discharge. Symptoms such as frequent urination and painful urination may also occur. Patients can use medications such as metronidazole tablets, clotrimazole vaginal tablets, or compound Huangbai liquid topical solution under a doctor's guidance.

4. Endometritis

Endometritis is an inflammatory condition of the endometrium caused by various infectious pathogens. Inflammation may lead to congestion, edema, or even necrosis of the endometrium in elderly individuals, causing irregular vaginal bleeding or bloody discharge. Additional symptoms may include lower abdominal pain and increased vaginal discharge. Patients should follow medical advice and use medications such as cefuroxime sodium injection, azithromycin dispersible tablets, and tinidazole injection.

5. Endometrial Polyps

Endometrial polyps result from localized excessive growth of the endometrial tissue. The surface of the polyps is rich in blood vessels, and bleeding may occur in elderly individuals during physical activity or emotional excitement, manifesting as postmenopausal irregular vaginal bleeding or bloody discharge. These are often accompanied by menstrual disorders, increased menstrual flow, and prolonged menstruation. Under medical supervision, patients may use medications such as Gongxue Ting granules, aminomethylbenzoic acid tablets, and cefdinir dispersible tablets.

To reduce the risk of vaginal bleeding, it is important to maintain good external genital hygiene, avoid sexual intercourse when vaginal dryness is present, and regulate hormonal balance to help prevent vaginitis and endometrial diseases.