instruction: hi doctor my mother is 58 years old her periods stopped in 2015 later she got her periods once in a year now from the last year blood like brown fluid came from her vagina when she go to toilet she do not feel pain or any other symptoms all test came positive and nothing seen in ultrasound no infection and no fibroid also please guide
output: hello blood mixed vaginal fluid in the postmenopausal women need to be evaluated cautiously and carefully although the common cause of such bleeding is due to deficiency of hormones once menopause is achieved the possibility of cervical and endometrial cancer needs to be ruled out ultrasound will not detect anything abnormal if the condition is still in an early stage for which microscopic evaluation of the cells needs to be done to see for any cancerous changes rarely the bleeding can be from the urinary tract or from the rectum which could be mistaken as vaginal bleeding too you need to get her a pap smear and hav human papilloma test testing done along with endometriosis evaluation to rule out both cervical and endometrial cancer possibility if possible please share her ultrasound reports to look for her endometrial thickness value please do not ignore these tests if not done previously I am assuming by getting her evaluated you have already gotten her examination done with a gynecologist if not then please make a visit to your gynecologist for her examination pap smear and hav testing endometrial aspiration with endocervical curettage us ultrasound for endometrial thickness