Help for fibroids postmenopause

Q:

My fibroids were problematic in my 40s, and my doctor advised a hysterectomy. I waited it out to avoid surgery, and the heavy bleeding stopped at menopause. But now, at 67, it seems the fibroids are acting up again and I’m bleeding. Is it time for that hysterectomy?

A:

Not necessarily. Once estrogen levels drop at menopause and fibroids go dormant, they rarely come out of hibernation to cause symptoms.

I counsel any patient with postmenopausal bleeding to see her doctor to rule out serious issues; but commonly, the cause is a fragile (atropic) uterine lining or thin vaginal tissues— one study found the incidence was as high as 89% among women with postmenopausal bleeding.

The good news? Hysterectomy is unnecessary and often the bleeding resolves on its own. To strengthen vaginal tissue, I suggest using a vaginal moisturizer containing aloe (such as Restore, Amazon.com) a few times weekly. But if your bleeding remains bothersome, see your doctor.

This sounds like vulvar contact dermatitis, a red rash that can itch or burn and affects up to 60% of women. It’s caused by prolonged exposure to an irritant—in your case, possibly the urine in the pad or friction from the pad rubbing against skin. Fortunately, there are simple remedies for your rash.

First, use a gentle pH-balancing cleanser to keep the area clean. Warm baths can soothe itching, as can applying an over-thecounter hydrocortisone cream. And applying a diaper rash cream or petroleum jelly can act as a barrier to protect your skin from urine. You can also try switching to a tampon-like bladder support product (like Poise Impressa Bladder Supports, drugstores). Inserted into the vagina, it supports the neck of the bladder to prevent leaks from ever occurring.

I wear pads to manage my light bladder leaks. They’ve been a lifesaver, but now I have an itchy rash down there.

Help!