- With Mayo Clinic internist
Sandhya Pruthi, M.D.
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Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
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Question
Hormone replacement therapy: Can it cause vaginal bleeding?
I'm taking hormone therapy for menopause symptoms. Recently, I've been experiencing heavy vaginal bleeding with clots. This occurs on a regular monthly basis — similar to a menstrual period. Should I be concerned?
Answer
from Sandhya Pruthi, M.D.
Some forms of hormone therapy for menopause may cause light, monthly bleeding. But hormone therapy should not cause heavy flow with clots, as you have described. This type of bleeding is abnormal and should be evaluated by your physician promptly.
Other potential causes of abnormal bleeding during or after menopause include:
- Shrinking or thinning of tissue lining the vagina and uterus due to a decrease in estrogen
- Uterine polyps or fibroids
- Infections of the uterus, such as endometritis and cervicitis
- Abnormal growth of the lining of the uterus (endometrial hyperplasia)
- Endometrial cancer
In addition to a careful history and physical examination, laboratory tests and diagnostic procedures may be used to identify the cause of abnormal bleeding in menopausal women.
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