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Menopause bleeding: causes

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The body of a woman is a complex system. During his life, he experiences a serious transformation, characterized by the restructuring of hormones: the first menstruation, pregnancy and menopause after 40 years. The number of eggs and hormones matured to fertilization, which are required for the normal functioning of the reproductive system with the onset of menopause, decreases.

Postmenopause is the last stage in the reformation of the reproductive function. This is the final cessation of menstruation, which signals the impossibility of the origin and development of pregnancy. But during this period, there may be abnormal bleeding during menopause, forcing women to see a doctor, stick to his appointments and long-term treatment.

Is bloody secret the norm?

Postmenopausal bleeding requires careful examination and the assistance of a physician. In time, significant failures in the functioning of the female organs are curable and completely passable. Blood excretions during this age period indicate the presence of a severe disease that is formed in the endometrium of the uterus. This may indicate the development of a tumor.

Menstruation is terminated, since this period is the end of female reproduction. Lack of menstruation, thinning of the mucous layer of the uterus, decrease in the size of the ovaries, lack of follicles - conditions unfavorable for conception are created in the body.

Problems with women's health at this age are not uncommon. They force a woman to seek medical help. The most common causes of discharge of blood can be caused by:

  • taking hormonal drugs
  • infections,
  • chronic female diseases
  • injury to the mucous walls,
  • maturation of the polyp
  • endometrial thickening,
  • myoma,
  • cancers.

Being in the reproductive age, for a woman, bleeding is considered a normal process, and takes place during menstruation. The natural derivation of the endometrial layer occurs when conception was not. The body is spontaneously released from excess cells. When rejection of the endometrium, as a result of vascular injury, blood uterine discharge occurs.

Read What is menopause in women and how it proceeds

During the period of menopause, the endometrial layer does not grow and is not displayed. Mucous discharge at this age becomes infrequent, and vaginal dryness is observed.

Due to changes in blood loss occurring in the body are excluded. This applies not only abundant, in the form of the usual monthly, but also secretions of mucus with streaks of blood.

In postmenopausal women, such indicators are not the norm and require serious examination.

Why there is a discharge with blood

The causes of blood discharge during menopause may be different. You can see them on linen, napkin or lining. If a woman has a similar condition, then it is necessary to make sure that their focus is located in the vagina, since the cause of blood can be damage to the urethra or rectum.

A prophylactic bleeding site will require a hygienic tampon. It must be inserted into the vagina (as in menstruation). If there are no traces of blood on it, then it is not uterine discharge. If a tampon with blood clots, you will need to contact a gynecologist. It symbolizes serious problems in the uterus or on its neck.

Menopause bleeding is a symptom of the following diseases:

  • vaginitis, vulvovaginitis and various inflammations (gonorrhea, chlamydia, trichomoniasis),
  • endometrial polyps and cervical canal,
  • uterine fibroids,
  • cancer of the uterus or cervix,
  • cancer of the uterus.

Menopause is characterized by a gradual cessation of the production of female hormones in the body. This causes not only general changes in the body, but also transformations on the mucous layer. The uterine lining becomes thinner and vulnerable, and partial atrophy occurs.

Each enhanced contact with the walls can lead to damage and will be accompanied by succinic secretions. Bleeding can be profuse or scanty.

They are caused by sexual intercourse, bike rides or other physical pressure on the abdomen or groin area.

Read What should be a diet for menopause

Vaginitis, vulvovaginitis

Diseases are the result of reduced immunity or abuse of antibiotics. Vaginitis occurs due to infections and viruses, as a result of diabetes or obesity, as well as hormonal imbalance, violation of the vaginal microflora.

Cases are not excluded when, during active sexual intercourse or poor-quality examination by a gynecologist, outside intervention occurs and the organs mucosa is damaged. This may be the cause of vaginitis.

A woman experiences discomfort in the vagina, drops of blood appear on the underwear, and sexual intercourse is accompanied by painful sensations. In some cases, dryness and unpleasant smell may occur.

Polypous formations become a source of bleeding. A polyp is a local growth of the surface (outer) tissue. Deviation may occur as a result of hormonal imbalance or occur during inflammation. Polyp is a benign neoplasm.

It develops due to chronic diseases of the uterus, physical damage to the mucous membrane. With polyps there is no pain, and reveals their gynecologist during the medical examination. Their presence may indicate abundant blood discharge during menopause, during sexual intercourse, as well as before and after menstruation.

They require early diagnosis and removal to eliminate their conversion to malignant nodes.

Uterine myoma

This type of benign growth develops in muscle tissue. According to statistics, it is formed in women at the initial stage of menopause and menopause.

In the process, the blood flow to the female organs is limited and the fibroids stop growing, disappear completely, without bringing any problems to the woman.

With the diagnosis of visible bloody discharge, in cases where the treatment is applied hormones and estrogenic herbal preparations.

Read Sex during menopause - all the nuances of sex life

Vaginal cancer

The disease is not observed often. But it is diagnosed in women in old age. Appearing education imperceptibly in the early stages and there is no possibility to detect it without the help of special diagnostic devices.

Over time, it grows and increases in size, leading to bloody and watery secretions of varying profusion, both intense and weak and irregular. Later, an unpleasant sensation of a foreign body arises in the vagina, pain during urination worries.

Upon detection of these symptoms, a visit to the doctor and a full examination for the detection of growth is necessary.

Cervical cancer

A fairly common disease of the female genital organs. According to statistics affects half a million women annually. About 30% of cases end with the death of the patient. Such malignant tumors are much more common than vaginal cancer. The cause is the papilloma virus.

In the early stages of development, a tumor is almost impossible to detect without inspection. But over time, blood and mucus are released from the vagina, sexual intercourse is accompanied by discomfort and pain.

You can prevent complications with regular tests and systematic visits to gynecological examinations.

Endometrial cancer

One of the most common diagnoses in women, with the most favorable and effective treatment.

The effect is achieved, as a result of timely diagnosis in the early stages, in this regard, it is possible to remove the tumor with the least loss to the woman's body. With cancer of the uterus, a woman feels a pain in the lower abdomen.

Education is felt by touch and has the appearance of a solid foreign body. Over time, the symptoms of the disease become:

  • general increased weakness
  • fast fatigue
  • blood or watery discharge from the genitals,
  • severe pain in the lower abdomen.

Read the drug Estowel in menopause - reviews of women, price, analogues

After the operation for the elimination and treatment of uterine cancer, patients are recommended to be examined frequently by the gynecologist. This is necessary to prevent re-growth of the tumor, as well as to regularly check the level of intoxication of the body with chemicals.

What to do

When detecting bloody discharge during menopause, it is necessary to establish the origin and location of the lesion that led to the bloodstream, to find the cause of such adverse symptoms.

Timely and qualitatively performed diagnostics of pathology gives a woman every chance of a full recovery. Gynecologists used in the treatment of scraping. This method performs research tasks.

It is hoped that after the procedure, the disturbing discharge will disappear. The procedure is capable of therapeutic therapeutic effect.

Patients over the age of 50 are effectively helped by the use of therapeutic agents that include androgens that can inhibit sexual function. To eliminate menopausal syndromes using conventional sedatives.

Along with the treatment recommended for the main disease, the gynecologist also draws attention to techniques aimed at the complete recovery of the female body.

To do this, you will need to change the diet - to increase the content of vegetables, fruits and dairy products, in particular cottage cheese.

In order to eliminate the negative effect of menopause and to avoid the transformations accompanying it in bone tissues, it is necessary to apply therapeutic exercises, use feasible loads with the help of sports, but first it is necessary to calculate them strictly. Activity and good mood can prolong youth and painlessly go through the menopause stage.

Bloody (brown) discharge during menopause | My Gynecologist

| My Gynecologist

In order to answer this question, it is necessary to figure out what we mean when we speak of climax.

Menopause does not occur instantaneously: the first symptoms of menopause may appear several years before the complete cessation of menstruation.

During this period, the menstrual cycle becomes irregular, menstruation becomes more or less abundant than usual, and sometimes instead of menstruation bloody discharge occurs.

That is, in this period of damping of the ovaries, which doctors call perimenopausal, spotting is not dangerous and can occur in normal conditions.

But if menopause has already arrived, that is, you have not had monthly or bloody discharge for at least 12 months in a row, the appearance of bloody discharge from the vagina is not normal and may indicate some disorders and diseases.

What do bleeding during menopause say?

In most cases, bleeding is not dangerous and speak of small disorders that can be successfully treated. However, one should not underestimate this problem, since in some women this discharge may indicate malignant diseases, such as cervical cancer, vaginal cancer, and uterine cancer.

When to contact a gynecologist?

Many women, knowing that during menstruation, the gynecologist does not perform a routine examination, wait until the end of the discharge and then go to the doctor.

However, in this situation it is best to turn to a gynecologist precisely when blood is still being released. This will help the doctor determine the source of blood (vagina, cervix or uterus), as well as assess the intensity of bleeding. These data will be very useful during diagnosis.

Reason 1: Age Changes in the Vagina

During menopause, the female hormones no longer produce sex hormones, which leads to changes in the vaginal mucosa, which becomes thinner.

Thinning of the mucous membrane of the vagina (atrophy) leads to the fact that even minor damage to it causes bloody discharge of varying degrees of profusion.

Generally, bleeding occurs during or after intercourse, but may also appear after masturbation, gymnastics, horse riding, cycling, etc.

Treatment: if you are sexually active and bleeding occurs predominantly during or after sex, then start using an artificial lubricant (lubricant), which can be purchased at a pharmacy. More information in the article Sexual life and menopause.

For severe vaginal dryness, your gynecologist may recommend the use of vaginal suppositories that contain estrogens. Thanks to these candles, the work of the vaginal mucosa is normalized.

If, in addition to dryness in the vagina, you have other symptoms of menopause (strong flushes of heat, sweating at night, etc.), then your gynecologist may prescribe hormone replacement therapy.

Reason 2: Inflammation of the vagina (vaginitis) and cervix (cervicitis)

Inflammatory processes in the genital tract can develop at any age, regardless of whether you live sexually. For example, candidiasis (thrush) can cause inflammation and bleeding after menopause, even if you are not sexually active.

If you live sexually, then the cause of inflammation can be sexually transmitted infections. Sexually transmitted diseases, such as gonorrhea, trichomoniasis, chlamydia, can cause not only inflammation of the vagina, but also inflammation of the cervix.

In addition to bleeding, there may also be a white, yellow or green discharge, an unpleasant smell in the intimate area, itching, discomfort, and a feeling of dryness in the vagina.

Treatment: depends on the results of the examination (smear on flora), which will help to clarify the diagnosis. Antifungal agents are used for candidiasis, antibiotics are prescribed for bacterial infections. After the end of the course of treatment, you will need to visit the gynecologist again and pass a second smear on the flora.

Reason 3: Cervical Polyp

Uterine cervix polyp is an overgrowth of mucous membrane, which has the appearance of a protrusion and can be easily damaged, causing the appearance of bloody discharge. The causes of polyps are unknown: they can be caused by chronic infections and inflammation, circulatory disorders or hormonal disorders.

Most polyps are benign in nature, but sometimes precancerous and cancerous changes can be found in a polyp. In order to clarify the nature of the polyp, the doctor may take a smear on cytology or perform a biopsy of the cervix.

Treatment: if the polyp of the cervix causes bleeding, is large, or the results of cytology and biopsy indicate possible undesirable changes, then the polyp is removed and then sent for histological examination.

Reason 4: Uterus Polyp

A uterus polyp is a proliferation of a portion of the endometrium (the inner layer of the uterus), which bulges into the uterine cavity. The polyp can have the most different sizes: from several millimeters to several centimeters. Most uterine polyps are of a benign nature, but sometimes they may contain cancer cells, or cells that can be reborn as cancer.

It is noted that uterine polyps often appear in women older than 40-45 years, and the reason for this may be hormonal changes occurring in the body during menopause.

To clarify the diagnosis, your gynecologist may prescribe an ultrasound of the uterus through the vagina (transvaginal ultrasound), hysteroscopy, or scrape the uterus.

Treatment: not all uterine polyps require treatment. If the polyp has a small size and benign nature, the treatment is not prescribed. However, you need to regularly visit a gynecologist, who will monitor how the polyp "behaves".

Removal of the polyp can be done during curettage of the uterus, or during hysteroscopy. The removed polyp is then sent for histological examination to clarify whether there are cancer cells in it. On our site there is an article devoted to this topic: Uterus polyps: causes, symptoms, treatment.

Reason 8: Uterine Cancer (endometrial cancer)

Endometrium is the uterine lining, so sometimes endometrial cancer is called uterine cancer (which is not entirely accurate, but more understandable). The main symptom of uterine cancer is bleeding or uterine bleeding.

Therefore, you should never underestimate the bleeding, if you already have menopause. The earlier the cancer of the uterus is detected, the more chances to cure it by removing the uterus.

In the diagnosis of endometrial cancer, uterine ultrasound, hysteroscopy, endometrial biopsy and other examination methods are used.

Treatment: depends on the type of cancer, its stage, your age and other factors. The main methods of cancer treatment are surgery, drug treatment (chemotherapy) and radiotherapy. On our site there is an article dedicated to this topic: Cancer of the uterus: causes, symptoms, treatment.

Spotting with menopause - when to see a doctor?

Menopause is the time in a woman's life in which the activity of the reproductive system of the body is reduced.Menopause does not occur simultaneously, but takes quite a long time: its first signs may occur a year before the complete disappearance of menstruation.

After the onset of menopause, the cycle of menstruation in a woman becomes irregular, the abundance of discharge changes.

At this time, the activity of the ovaries gradually decreases, so the occurring minor bleeding is considered normal.

However, if a woman is in the period of post-menopause and has not seen menstruation for more than a year, but at one point she has discharge with blood, you can safely suspect that she has a disorder of the reproductive system.

Often, such bleeding does not carry a great danger to the woman, indicating only minor irregularities in her body, and easily disappears after the start of treatment.

However, not all women, they are only a signal of a slight violation: in rare cases, bleeding indicates the presence of dangerous and complex diseases - cancer of the uterus and vagina, frequent mates of the fair sex after menopause.

During early menopause, bleeding is often the faithful companions of women. But after its occurrence, they should stop, but if this did not happen within one year, the disease was probably the cause of the prolonged bleeding.

The main causes of bleeding (according to doctors) are a decrease in the amount of estrogen in the body or their replacement by similar preparations. Often bleeding occurs due to the growth of a malignant tumor.

Uterine discharge

When the time of menopause passes, the production of estrogen (the female's sex hormones) stops abruptly, the ovaries do not produce eggs, and the menstruation ends.

Reducing the amount of estrogen contributes to atrophy and relaxation of the uterine walls, reducing the tone of blood vessels: the walls of blood vessels weaken and break, which can cause bloody or brown discharge during menopause and after it.

Vaginal discharge

Another cause of bleeding during menopause can be draining the vagina.

After menopause, atrophy of the vaginal secretory glands occurs, which is manifested in frequent inflammatory processes, a decrease in the amount of lubricant and a decrease in vaginal tissue.

All this often contributes to the destruction of the vaginal layer: the tissue is torn, which causes bloody discharge. Often they occur during intercourse with pain and itching.

Hyperplasia

A common phenomenon after menopause is the growth of uterine cells, called hyperplasia. Cell growth can be either benign or malignant, but in any case it causes abundant blood loss by uterine tissues. Hyplasia bloody discharge often contains lumps and scraps of uterine epithelium.

Fibroma of the uterus. Polypous growths

Fibroma of the uterus and the growth of polyps often cause the appearance of mucus or uterine bleeding in women during post menopause, usually arising along with pain in the lower abdomen or in the vagina. Fibroma causes more extensive bleeding than polyps.

To reduce the appearance of menopause, women prefer to take hormones. Such treatment often helps to get rid of sweating, hot flashes, and normalize weight, but can contribute to the appearance of excessive epithelium, which is enlarged by the uterus. Thus, bleeding is a substitute for menstruation for the body after the onset of menopause.

Treatment of bleeding during post menopause

The bleeding that appears during menopause is studied by a gynecologist with a curettage used for diagnostic purposes.

Often, after curettage, discharge from women is stopped once and for all - surprisingly, but curettage also has a therapeutic effect. If a woman is characterized by recurrent and abundant blood loss, her hormonal background is studied, and after the doctor prescribes hormone therapy.

Women under 50 are prescribed hormones of the corpus luteum, and women of later age (after 50 and over) - androgens, which suppress their sexual function. Ordinary sedatives and hormonal drugs in small dosages will be effective for general relief of menopause symptoms.

In addition to treating the underlying disease that caused the bleeding, the woman’s gynecologist should pay particular attention to general health procedures after menopause.

For example, rationalization of their food will be especially useful for women after menopause: including cottage cheese, fresh fruits and vegetables in the daily menu.

To reduce the likelihood of unpleasant phenomena in the pelvis, a woman should lead a more active lifestyle in her free time, do a gymnast, do physical therapy, and drink plenty of pure water.

What is possible during menopause?

The menopause period begins at the age of 50. Clinically, it is expressed in the form of cessation of the menstrual cycle, the cause of which was age-related ovarian dysfunction.

Climacteric period does not occur instantly. For 9–12 months, the woman undergoes premenopause — a restructuring of the body, characterized by:

  • irregular cycle
  • bleeding instead of reg.

The occurrence of spotting is associated with the gradual cessation of ovarian function. During premenopause, their presence carries no danger.

Menopause is characterized by a long absence of critical days (about 12 months). Smearing spotting that appeared 1 year after the last menstruation may indicate a serious gynecological pathology or disease.

What can be caused by discharge during menopause?

Determining the cause of excretions

Age-related changes of the vaginal microflora

With the onset of menopause, the ovaries stop the production of estrogen sex hormones:

This leads to a change in the qualitative composition of cervical mucus and thinning of the epithelium - the mucous membrane lining the vagina. Any mechanical injury or minor damage may result in bleeding. Usually their secretion increases after intercourse.

Inflammatory processes of the genital tract

The most common types of inflammation are:

  • vaginitis - inflammation of the vagina
  • cervicitis - inflammation of the cervix,
  • candidiasis - thrush.

If a woman who has reached menopause continues to practice sex, then infections and STDs can cause an inflammatory process.

Bleeding causes bacteria of the following types:

  • gonococci
  • Trichomonas vaginal,
  • chlamydia.

Cervical Polyps

The formation of a polyp leads to the proliferation of the epithelial membrane. Its tissues are easily damaged, which also leads to the appearance of secretions.

According to medical research, the presence of bleeding during menopause is associated with impaired carbohydrate and fat metabolism. The appearance of a secret can be caused by the following pathologies:

  • diabetes mellitus
  • obese
  • arterial hypertension - persistent high blood pressure.

Causes of secretions due to ovarian removal

Women of reproductive age who have undergone surgery to remove the ovaries. susceptible to menopause syndrome. Patients decrease the secretion of female hormones, which leads to the inevitable restructuring of the body and changes in the mucous membrane:

  • the epithelial layer becomes thinner,
  • There is a dry vagina.

Minimal injuries and microcracks usually lead to the appearance of brown bloody discharge.

How to determine the cause of the pathology?

In order to establish the cause of the appearance of vaginal bleeding, the gynecologist uses complex research methods. Usually they include:

  • palpation of the uterus,
  • examination of the pelvic organs with ultrasound,
  • tissue biopsy - collection of biological material for clinical research for the presence of degenerative changes,
  • bacteriological seeding
  • other laboratory methods for the study of vaginal microflora.

Menopause is considered the most dangerous for women.

In connection with the termination of secretion of hormones by the ovaries, the mucous membrane stops performing barrier functions - the functions of protecting the body against microbial pathogens of gynecological pathologies.

In the event of bleeding, the patient should immediately contact an experienced doctor to eliminate the risk of cancer.

Spotting after menopause

Bleeding in the early menopause stage is quite normal. However, if you have bleeding after menopause, it is worth a visit to the doctor, perhaps the cause of the selection are other diseases. For women, the period after menopause can be considered a period of one year after the end of the menstrual cycle.

The cause of bleeding or bleeding after menopause is often a decrease in estrogen level or its replacement with any drugs. It is important to visit a doctor if you notice spotting after menopause.

This may indicate a malignant tumor. This article will describe the main possible causes of postmenopausal bleeding. I emphasize, if you notice the selection, be sure to consult with a specialist.

You do not need to press until the doctor comes to you, it is better to go to him.

During menopause and after it ends, the production of estrogen (female sex hormone) drops sharply and because of this, the ovaries stop the production of eggs and the woman's menstruation disappears.

Reducing the level of estrogen in the body leads to relaxation of the walls of the uterus, causing atrophy.

The blood vessels present in the walls of the uterus also become very weak and often tear, resulting in red and brown spotting during the various phases of menopause.

Spotting after menopause can also be associated with vaginal dryness, which can lead to vaginal atrophy.

Vaginal atrophy is an inflammation of the vagina, which is caused by a decrease in lubrication and narrowing of the tissues of the vaginal layer. This condition can lead to the destruction of the vaginal lining, causing bleeding or bleeding.

During intercourse, it can also lead to bleeding, along with itching and burning pain, despite the general dryness of the vagina.

female problems Blood bleeding after menopause A rapid increase in the number of uterine cells, called hyperplasia, can also cause bleeding after menopause.

Different color of discharge during bleeding after menopause may indicate a malignant tumor, so you should consult a doctor if you notice bleeding after menopause.

The doctor will refer you to an oncologist for a full examination for uterine cancer called endometrial cancer.

Another cause of postmenopausal bleeding may be the formation of fibroids and polyps in the postmenopausal cavity of the uterus. Discharge may be accompanied by pain in the lower abdomen or vagina. Fibroids can cause more severe bleeding after menopause than polyps.

Side effects of drugs

To alleviate the symptoms of menopause, women often use hormone replacement therapy (HRT).

This therapy brings the necessary relief to menopause symptoms, such as night sweats, hot flashes and weight gain, but causes excessive build-up of the uterine mucosa by replacing estrogen with another hormone, resulting in uterine bleeding after menopause.

If vaginal bleeding after menopause is accompanied by pain or pressure on the muscles of the pelvic floor, abnormal stool or bloody discharge from the vagina, talk to your doctor about it as soon as possible. __

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Discharge during menopause

Due to the nature of the female body after the onset of menopause (cessation of menstruation), any discharge that has a character other than mucous membranes should be considered pathological. Therefore, their manifestation requires consultation with a gynecologist.
Allocation during menopausal pause in women is classified as follows:

  • by the presence of smell,
  • in composition and consistency,
  • in appearance.

Given these criteria, the allocation in the period of the onset of menopause are:

  • consisting of mucus -transparent or having a slight yellow tint,
  • purulent character - thick, characteristic yellow or white color,
  • resembling cottage cheese,
  • containing blood.
  • What discharge during menopause is considered the norm and pathology?

Let us consider in more detail what excretions are possible during climax.

Discharges containing blood

Discharge during menopause, containing blood, may be precursors of cancer. If during this period a woman is undergoing a course of hormone replacement therapy (HRT), then bleeding that is not rich is the norm rather than pathology.

In addition, it should be borne in mind that climax is a long-term process. He is considered to have arrived at the expiration of twelve months since the last menstruation. Therefore, in this period of time, bleeding caused by changes in the vagina or uterus, as well as rare periods. However, a visit to the doctor in such a situation is a must.

Allocation after menopause

Causes of discharge after the onset of menopause are mainly any pathology. Therefore, their presence is a direct message to immediately go to the hospital. For example, prolonged watery discharge is likely to indicate the presence of a tumor in the fallopian tube.

If the discharge is bloody, this is one of the symptoms of both benign (fibroid) and malignant tumors of the cervix or the uterus itself. Sometimes such secretions speak of ovarian tumors.

Non-neoplastic diseases of postmenopausal disease that can manifest as bleeding from the genital organs include vaginitis, colpitis (most often senile), erosion, and polyps of the cervix. These diseases are caused by changes in the uterus, on the walls of the vagina, external genitals.
Also the causes of bleeding are the following pathologies and factors:

  • diseases of the cardiovascular system
  • problems with blood clotting,
  • continuation of sexual life
  • the use of drugs containing hormones that are contraindicated in this age group.

In the period of menopause, the fair sex should not forget about health for a minute. Promises and reservations on age in this case are categorically unacceptable. It should be understood that if earlier any unplanned bleeding could be explained by hormonal surges or malfunctions, then after menopause they act as harbingers of very serious diseases.

No need to listen to the advice of girlfriends, and at the slightest manifestations of discharge with blood, especially in the postmenopausal period, it is necessary to contact the hospital and conduct an examination to determine and promptly eliminate their causes. Health to you!

Sources: http://healthy-lady.ru/vydeleniya-pri-klimakse, http://healer-beauty.ru/krovyanistye-vydeleniya-posle-menopauzy/, http://aboutbody.ru/vyideleniya-pri-klimakse -norma-i-patologiya-prichinyi-poyavleniya-vyideleniy-posle-nastupleniya-klimaksa /

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