Post menopausal bleeding – what can it possibly be?

What is postmenopausal bleeding?

Postmenopausal bleeding is any bleeding that occurs in a woman’s vagina after she has undergone menopause. Once a woman has gone 12 months without a period, she’s considered to be menopausal.

In order to rule out serious medical problems, women with postmenopausal bleeding should always see a gynecologist.

What is vaginal bleeding?

Vaginal bleeding can have a variety of causes. These include normal menstrual cycles and postmenopausal bleeding. Other causes of vaginal bleeding include:

  • trauma or assault
  • cervical cancer
  • infections, including urinary tract infections
  • Polyps
  • Endometrial hyperplasia
  • Fibroids

If you’re experiencing vaginal bleeding and are postmenopausal, your Gynecologist will ask about the duration of the bleed, the amount of blood, any additional pain, or other symptoms that may be relevant.

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Because abnormal vaginal bleeding can be a symptom of cervical, uterine, or endometrial cancer, you should get any abnormal bleeding evaluated by a gynecologist immediately .

What causes postmenopausal bleeding?

Bleeding can occur in postmenopausal women for several pathological reasons. For example, women who take hormone replacement therapy for menopause may have vaginal bleeding for a few months after starting the hormones. It’s also possible for a woman who thought she was in menopause to begin ovulating. If this occurs, bleeding may also occur.

There are a variety of other conditions that can cause postmenopausal bleeding such as polyps, endometrial hyperplasia, and endometrial atrophy.

Uterine polyps

Uterine polyps are noncancerous growths. Though benign, some polyps may eventually become cancerous. The only symptom most patients with polyps will experience is irregular bleeding.

Uterine polyps are particularly common in women who have gone through menopause. However, younger women can also get them.

Endometrial hyperplasia

Endometrial hyperplasia is the thickening of the endometrium. It is a potential cause for postmenopausal bleeding. It is often caused when there is an excess of estrogen without enough progesterone. It occurs frequently in women after menopause.

Long-term use of estrogen can lead to increased risk of endometrial hyperplasia. It can ultimately lead to cancer of the uterus if not treated.

Endometrial cancer

Endometrial cancer begins in the uterus. The endometrium is a layer of the uterus. In addition to abnormal bleeding, patients may experience pelvic pain.

This condition is often detected early. It causes abnormal bleeding, which is easily noticed. The uterus can be removed to treat cancer in many cases. Less than 10% of women who have postmenopausal bleeding have endometrial cancer.

Endometrial atrophy

This condition results in the endometrial lining becoming too thin. It can occur in postmenopausal women. As the lining thins, bleeding may occur.

Cervical cancer

Bleeding after menopause is often harmless. However, it can also be a rare sign of cervical cancer. Cervical cancer tends to progress slowly. Gynecologists can sometimes identify these cells during a regular exam.

Annual visits to the gynecologist can help with early detection and even prevention of cervical cancer. This can be done by monitoring for abnormal Pap smears.

Other symptoms of cervical cancer can include pain during sex or abnormal vaginal discharge, including in women who are postmenopausal.

Symptoms of postmenopausal bleeding

Many women who experience postmenopausal bleeding may not have other symptoms. But symptoms may be present. This can depend on the cause of bleeding.

Many symptoms that occur during menopause, like hot flashes, often begin to decrease during the postmenopausal time period. There are, however, other symptoms that postmenopausal women may experience.

Symptoms postmenopausal women may experience include:

  • vaginal dryness
  • decreased libido
  • insomnia
  • stress incontinence
  • increased urinary tract infections
  • weight gain

Why Dr. Ruchi Tandon is the best choice?

Dr. Ruchi Tandon is a gynecologist with over 13 years of experience in clinical menopause and is a trained Hysteroscopy surgeon, practicing in leading hospitals of South Delhi such as Max smart super specialty hospital, Saket, Apollo Cradle Royale, Nehru Place. She specializes in hormone replacement therapy and recommended the management of menopausal symptoms.

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