When a female goes through menopause, she does not expect to have vaginal bleeding after that. However, a female may at times experience additional vaginal bleeding. If she has undergone menopause, a gynecologist would consider the bleeding abnormal, and the female should get medical help without delay.
Causes of bleeding after menopause
Postmenopausal vaginal bleeding can be due to a number of reasons. Some of the most common causes can include-
- Endometrial atrophy- When estrogen stops being produced after menopause, a female’s endometrial lining may start becoming thinner. As a result, the lining of the uterus may be more likely to bleed.
- Endometrial hyperplasia- This condition causes the endometrium (uterine lining) to become thicker instead, causing heavy or irregular bleeding. The cause of this condition is commonly excessive estrogen levels without progesterone to offset it. It can at times also lead to the development of endometrial cancer.
- Endometrial cancer- It is the cancer of the endometrial lining. An estimated 10 % of postmenopausal females with uterine bleeding experience vaginal bleeding due to endometrial cancer.
- Uterine Polyps– Polyps are usually non-cancerous growths that can develop on the lining of the uterus but can cause unusual or heavy bleeding. Polyps can at times grow inside the cervical canal. In this case, the female may have bleeding when she has sex.
Other less likely but potential causes of postmenopausal bleeding can include-
- Clotting problems
- Trauma to the pelvis
- Endometritis (infection of the uterine lining)
- Thyroid disorders
- Bleeding from the urinary tract
Regardless of the potential cause of the bleeding, it is important that the female sees her gynecologist when she has vaginal bleeding after menopause.
Diagnosis for postmenopausal vaginal bleeding
A gynecologist will start an exam for bleeding after menopause by asking the female about the symptoms she might be experiencing. A gynecologist will likely ask questions such as-
- When the female first noticed her symptoms?
- How much bleeding is she having?
- Does she have any family history of bleeding after menopause?
Depending upon a female’s symptoms, a gynecologist may recommend one or more tests to diagnose the condition, including-
- Dilation and curettage (D&C )
- Endometrial biopsy
- Transvaginal ultrasound
Also Read: 10 Health Risks Women Face After Menopause
Treatment options for postmenopausal vaginal bleeding
Treatments for postmenopausal vaginal bleeding depends upon the underlying cause of the bleeding. Some treatment options, depending on the causes of vaginal bleeding after menopause may include-
- Polyps: Treatment option of polyps mostly includes surgical removal of the polyp so that it does not bleed.
- Endometrial cancer- Often, treatment for endometrial cancer is the removal of the uterus along with any nearby lymph nodes which may be affected by cancer. The doctor carries out the surgery of hysterectomy to remove the uterus. Depending on cancer’s spread, a female may also need treatments like chemotherapy and radiation treatments.
- Endometrial hyperplasia- Females who have endometrial hyperplasia may be prescribed progestins to help prevent the endometrial lining from getting too thick. However, the gynecologist may suggest regular testing for any cancerous cells inside the uterus to make sure that they do not have endometrial cancer.
An estimated 4 to 11 % of females experience vaginal bleeding after they go through menopause.
Females can expect to experience irregular bleeding before menopause, during the period of perimenopause. But, vaginal bleeding is not normal after menopause.
Although bleeding after menopause is not always a call for concern, a female should always consult her gynecologist if she ever experiences postmenopausal bleeding in order to rule out serious causes including endometrial cancer.