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Can Stress Cause Menstrual Bleeding After Menopause

How Is It Treated

Can you get your period again after menopause – What does bleeding after menopause mean

That depends on whatâs causing the bleeding.

Estrogen therapy: This hormone is used to treat vaginal and endometrial atrophy. Your doctor may prescribe it in one of the following forms:

  • Pills: Youâll take them by mouth.
  • Vaginal cream: Youâll use an applicator to get it inside your body.
  • Vaginal ring: You or your doctor can put it in place. It releases a steady dose of estrogen for about 3 months.
  • Vaginal tablet: Youâll insert it using an applicator. You may need to do it daily, or a few times a week.

Progestin therapy: This lab-made version of progesterone is used to treat endometrial hyperplasia. Your doctor may prescribe it in a pill or shot, a vaginal cream, or intrauterine device.

Hysteroscopy: This procedure can remove polyps. Doctors also use it to remove thickened parts of the uterine lining caused by endometrial hyperplasia. Theyâll insert a hysteroscope into your vagina and pass tiny surgical tools through the tube.

D& C : In this surgery, the doctor opens your cervix. . They use a thin tool to remove polyps or thickened areas of the uterine lining caused by endometrial hyperplasia.

Hysterectomy: This surgery removes part or all of your uterus. Itâs a treatment for endometrial or cervical cancer. Some people with a precancerous form of endometrial hyperplasia may also need it. In some cases, the doctor may also take out your ovaries, fallopian tubes, or nearby lymph nodes.

What Is The Most Common Cause Of Postmenopausal Spotting

Having a period after menopause can be alarming, but theres not one most common cause. Theres a range of causes of postmenopausal spotting not all of them serious but all requiring a check-in with your doctor.

Causes of postmenopausal bleeding include:

  • Polyps these are non-cancerous tissue growths that can form anywhere in your cervix, uterus, or cervical canal.

  • Endometrial Hyperplasia This is the thickening of your uterine lining caused by an imbalance of hormones, specifically too much estrogen and not enough progesterone. Cells in the uterine lining can become abnormal, and can sometimes lead to cancer.

  • Endometrial Atrophy This is the thinning of the uterine lining, caused by very low hormone levels.

  • Vaginal atrophy This is the thinning of the vaginal walls, again, caused by low hormone levels experienced after menopause. The lining of the vaginal walls can become dry and inflamed, especially after sex.

  • Cancer Postmenopausal bleeding is the most common symptom of certain types of cancers, including endometrial, uterine, cervical, and vaginal cancers. Although serious, only around 9% of postmenopausal women who sought medical advice for vaginal bleeding were diagnosed with cancer. So you dont have to assume the worst.

  • HRT treatment spotting can be a common side effect of Hormone Replacement Therapy which can be a common cause in itself for endometrial hyperplasia.

  • Other factors including STIs, medications, and vaginal infections.

Can Emotional Stress Cause Spotting During Menopause

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How Is Postmenopausal Bleeding Treated

Treatment for postmenopausal bleeding depends on its cause. Medication and surgery are the most common treatments.

Medications include:

  • Antibiotics can treat most infections of the cervix or uterus.
  • Estrogen may help bleeding due to vaginal dryness. You can apply estrogen directly to your vagina as a cream, ring or insertable tablet. Systemic estrogen therapy may come as a pill or patch. When estrogen therapy is systemic, it means the hormone travels throughout the body.
  • Progestin is a synthetic form of the hormone progesterone. It can treat endometrial hyperplasia by triggering the uterus to shed its lining. You may receive progestin as a pill, shot, cream or intrauterine device .

Surgeries include:

Anovulatory Or Dysfunctional Uterine Bleeding


Dysfunctional uterine bleeding is the occurrence of uterine bleeding unrelated to structural abnormalities of the uterus or the endometrial lining. It is a diagnosis of exclusion made after structural causes of bleeding and chronic medical diseases have been ruled out. Other causes of abnormal bleeding must also be ruled out, including pregnancy complications and medications that influence hormonal action or affect clotting. Dysfunctional bleeding occurs more commonly in the first five years after a woman starts menstruating and as she approaches menopause, but it can occur at any time period. The cause of DUB is anovulation, the absence of ovulation and the orderly secretion of estrogen and progesterone, and may alert the woman and her physician to the fact that she is no longer ovulating normally.

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There Are Several Potential Causes But Some Are More Serious Than Others

In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy , vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancera malignancy of the uterine lining, but only in a small number of cases. A 2018 study by the National Cancer Institute found that only about 9 percent of postmenopausal women who saw a doctor for bleeding later received a diagnosis of endometrial cancer.

Still, we want the option to intervene early if it is cancer, since treating it sooner leads to better outcomes, Mantia-Smaldone said.

If endometrial cancer is found early, a woman has a 95 percent chance of surviving the cancer for at least 5 years.

Pituitary And Glandular Dysfunction

Disorders of the pituitary and thyroid glands can cause anovulation and menstrual irregularity. Individuals with inadequate production of thyroid hormone can be treated with daily oral replacement of thyroid hormone. Excess thyroid hormone production may be treated with oral medications, radioactive iodine, or surgical removal of all or part of the thyroid gland. The treatment of hyperprolactinemia is generally treated with the oral medication cabergoline or bromocriptine. Individuals with elevated levels of prolactin may be advised to have an imaging study, such as a CT scan or MRI, of the pituitary gland to determine if there is evidence of a pituitary lesion. Pituitary adenomas are the most common benign tumors of the pituitary gland and are often associated with excessive release of prolactin. If pituitary adenomas are large, they may be treated surgically. Sometimes changes in exercise and/or dietary habits can cause changes in many of these hormones and lead to irregular bleeding. Such lifestyle changes cause FSH and LH to be very low or close to undetectable and this may suggest a proper evaluation. An elevated FSH level may indicate impending ovarian failure, either due to menopause or to early menopause, also known as premature ovarian failure . For more information on POF, refer to the ASRM patient information factsheet titled Premature Ovarian Failure.

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Things To Know About Postmenopausal Bleeding

Spotting or light bleeding after menopause might not seem like a serious problem, but you should never ignore it or wait to bring it up with your doctor. After a womans periods have stopped, vaginal bleeding could be a sign of a health issueincluding endometrial cancer. Heres what every postmenopausal woman should know.

Hyperplasia And Uterine Cancer

Postmenopausal Bleeding – Dr. Rubina Shanawaz

Bleeding caused by changes in the uterus is potentially more serious, so anything you can do for prevention is worth being aware of. Losing weight is one important way to prevent some of these changes. Studies have shown that when a woman carries more adipose tissue on her body, there is a greater statistical risk for hyperplasia and some forms of uterine cancer. This may be because excess fat both creates and stores estrogen and estrogen-mimicking compounds, which overstimulate that uterine lining throughout the years.

Systemic estrogen therapy is another known risk factor for uterine cancer including the use of bioidentical forms like estradiol. But remember, every woman is unique, and some can tolerate HRT much better than others. A frank discussion with a healthcare provider you trust, who knows your history and really listens to you, is key in determining whether HRT is right for you. If you do go that route, be sure you check your hormone levels on a regular basis. I check my bioidentical hormone replacement therapy patients twice a year to be sure they are appropriately balanced. If your medical provider isnt doing so, dont be afraid to ask for it. Be proactive when it comes to your health!

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The Diagnostic Process May Involve Multiple Steps

Even though postmenopausal bleeding can have a number of different causes, your doctors first objective is to rule out potential cancers.

Well usually do a physical exam to look for blood or masses, such as fibroids, followed by an ultrasound to see how thick a patients uterine lining is, Mantia-Smaldone explained. A postmenopausal womans uterine lining should be quite thin, since she isnt menstruating.

Endometrial cancer can cause the lining of the uterus to thicken. If your uterine lining appears thicker than normal, your doctor will recommend a biopsy, in which a sample of your uterine lining is removed and examined under a microscope.

How Can Nutrition Help

If you are experiencing postmenopausal bleeding, including foods high in iron into your diet may help to manage your symptoms, as they introduce risks of becoming anaemic, or experiencing symptoms such as tiredness and dizziness. For instance, you might eat more red meat, organ meats, green leafy vegetables, beans, and lentils.

A diet high in antioxidants such as vitamin A, C, E, and selenium as well as zinc, vitamin D, and omega 3 can also be beneficial in the prevention of cancer or general inflammation in the body.

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Why Am I Bleeding Between My Periods

Bleeding between periods can be caused by serious or benign causes. The most dangerous causes often involve pregnancy. A failed pregnancy, a pregnancy in which the egg implants in the fallopian tube, disconnection of the placenta from the uterus, or damage to the uterus can all cause bleeding. If you suspect any of these causes, you should seek medical evaluation as soon and as safely as possible. Otherwise, uterine fibroids, tumor, blood thinners, ruptured ovarian cysts and gynecological infections, and changes in contraceptive drugs can cause spotting.

What Is Vaginal Bleeding

Post Menstrual Bleeding Symptoms How Help

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

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

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

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What Causes Postmenopausal Bleeding

Bleeding can occur in postmenopausal women for several reasons. For example, women who take hormone replacement therapy may have vaginal bleeding for a few months after starting the hormones. Its 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.

Some common causes include: polyps, endometrial hyperplasia, and endometrial atrophy.

Is Bleeding After Menopause Always Cancer

While cancer isnât the only or even the most common cause of postmenopausal bleeding, itâs still important to see your doctor if you have bleeding after menopause. More than 90% of women who have endometrial cancer experience abnormal vaginal bleeding and early diagnosis greatly increases the likelihood of successfully treating cancer.

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How Do Doctors Diagnose Bleeding After Menopause

To find the cause of abnormal vaginal bleeding, your doctor will perform a physical exam and ask about your family and health history. He or she may also order a transvaginal ultrasound or an endometrial biopsy.

Transvaginal ultrasonography allows your doctor to assess your uterine cavity and endometrial thickness. He or she can also examine your fallopian tubes and ovaries. During this procedure, your doctor or an ultrasound technician will place an instrument into the vagina to examine the uterine cavity and endometrial lining. This instrument will emit sound waves that bounce off the pelvic organs. These sound waves get sent to a nearby computer and create a picture called a sonogram.

Endometrial biopsy, or endometrial sampling, involves removing a small piece of the endometrial lining. After taking the sample, the doctor will send it to the lab. There, the scientists will look for anything abnormal, including signs of infection or cancer.

Can You Spot After Menopause

Can bleeding during menopause be detrimental? | Dr. Sanchaita Das

Yes. As weve outlined above, there are various reasons for spotting after menopause. Most will require an examination or procedure to diagnose. Your doctor may refer to postmenopausal bleeding ICD 10, which is the International Classification of Diseases, regarding further testing or investigations they recommend.

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Will Perimenopause Ever End

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in estrogen accelerates. At this stage, many women may experience menopause symptoms. Women are still having menstrual cycles during this time, and can get pregnant.

Are There Herbal Remedies To Help Me

  • Stress Relief Daytime this is a licensed herbal remedy which contains fresh extracts of Valerian and Hops. It has a calming effect on the nervous system
  • Passiflora this is a plant which originates from South America and the East Indies
  • Avena sativa – this is an extract of oat straw and has been used as a nerve tonic for hundreds of years. It contains substances such as Gramine and vitamin B, important for the normal function of the nervous system
  • Flower Essences there is a range of Jan de Vries flower essences including Female Essence, Emergency Essence and Relaxation Essence, which are designed to help with the different emotional aspects of the menopause.

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What You Can Do

Consider keeping a journal to track your periods. Include information such as:

  • when they start
  • whether you have any in-between spotting

You can also log this information in an app, like Eve.

Worried about leaks and stains? Consider wearing panty liners. Disposable panty liners are available at most drugstores. They come in a variety of lengths and materials.

You can even buy reusable liners that are made of fabric and can be washed over and over again.

When your estrogen levels are high in comparison to your progesterone levels, your uterine lining builds. This results in heavier bleeding during your period as your lining sheds.

A skipped period can also cause the lining to build up, leading to heavy bleeding.

Bleeding is considered heavy if it:

  • soaks through one tampon or pad an hour for several hours
  • requires double protection such as a tampon and pad to control menstrual flow
  • causes you to interrupt your sleep to change your pad or tampon
  • lasts longer than 7 days

When bleeding is heavy, it may last longer, disrupting your everyday life. You may find it uncomfortable to exercise or carry on with your normal tasks.

Heavy bleeding can also cause fatigue and increase your risk for other health concerns, such as anemia.

What Causes Bleeding After Menopause

What Are the Causes of Postmenopausal Spotting ...

Bleeding after menopause is rarely cause for concern. It does need to be investigated, however, because in very few cases it will be an indicator of something more serious.

In about 90 per cent of cases, a particular cause for bleeding after menopause will not be found. This is not a cause for alarm, if there is a serious problem it will be identified through investigations. Most of the time, postmenopausal bleeding is caused by:

  • inflammation and thinning of the lining of your vagina
  • thinning of the lining of your uterus
  • growths in the cervix or uterus which are usually not cancerous
  • thickened endometrium often because of hormone replacement therapy
  • abnormalities in the cervix or uterus.

These are generally not serious problems and can be cured relatively easily.

However, about 10 per cent of the time, post-menopausal bleeding is linked to cancer of the cervix or uterus and so it is very important to have it investigated.

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