Not Sure What To Do Next
If you are still concerned about bleeding after menopause, use healthdirects online Symptom Checker to get advice on when to seek medical attention.
The Symptom Checker guides you to the next appropriate healthcare steps, whether its self care, talking to a health professional, going to a hospital or calling triple zero .
How Much Bleeding Is Normal After Menopause
You may think you have reached menopause if you have not had a period for a few months. However, it is still possible to have a period up to a year after your last one. After 12 months without a period, any bleeding at all is not normal.
Up to 1 in 10 women experience bleeding or spotting after their menopause. In most cases the bleeding is not serious and a cause may not be found. However, it needs to be checked because sometimes it can be a sign of cervical or uterine cancer, so it is always important to see a doctor if you notice any vaginal bleeding after menopause.
I Have Postmenopausal Bleeding Do I Need To See A Doctor
Yes, you should always visit your GP or make an appointment with a gynaecologist if you notice any postmenopausal bleeding, even if it has only happened on one occasion. This includes minor spotting or brown/pinkish discharge.
At London Womens Centre, we are specialists in womens health problems, including postmenopausal problems and abnormal bleeding. To discuss your symptoms in confidence, book a consultation with us today.
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What Causes Uterine Cancer Vs Fibroids
Being exposed to X-rays can increase the risk of uterine sarcoma.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesnât mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for uterine sarcoma include the following:
- Past treatment with radiation therapy to the pelvis.
- Treatment with tamoxifen for breast cancer. If you are taking this drug, have a pelvic exam every year and report any vaginal bleeding as soon as possible.
The exact reasons why some women develop fibroids are unknown. Fibroids tend to run in families, and affected women often have a family history of fibroids. Women of African descent are two to three times more likely to develop fibroids than women of other races.
Fibroids grow in response to stimulation by the hormone estrogen, produced naturally in the body. These growths can show up as early as age 20, but tend to shrink after menopause when the body stops producing large amounts of estrogen.
Fibroids can be tiny and cause no problems, or they also can grow to weigh several pounds. Fibroids generally tend to grow slowly.
The following factors have been associated with the presence of fibroids:
- Never having given birth to a child
- Onset of the menstrual period prior to age 10
- African American heritage
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.
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But Here Is Why You Really Need To See Your Doctor
Endometrial cancer, which affects 2% to 3% of American women, is the most common type of gynecological cancer. According to the American Cancer Society, it most often affects postmenopausal women 60 is the average age at diagnosis. There is currently no way to screen for endometrial cancer. Identifying it early has become a pressing issue, because the incidence of this cancer has risen gradually but steadily over the past 10 years, according to the National Cancer Institute.
Endometrial cancer is a fairly common disease, and its unfortunately becoming more common due to the growing rates of obesity, says Dr. Berkowitz. A womans risk of endometrial cancer can increase substantially if she is obese. Generally, risk rises among women who are 50 pounds or more above their ideal body weight, he says.
This is because of the role estrogen plays in endometrial cancer. The most common type of endometrial cancer, known as type 1 cancer, is fueled by estrogen. Estrogen is produced by body fat, so women with a larger amount of fatty tissue generally have higher levels of estrogen. They also typically have more free estrogen, an active form that produces stronger effects. This may lead to cancerous changes in the uterine lining.
Is It Normal To Bleed Years After Menopause
The short answer to this question is no. Postmenopausal women shouldnât experience bleeding because menopause is the end of a womanâs menstrual cycle. While some women do experience postmenopausal vaginal bleeding, this type of bleeding isnât normal. As a result, you should visit your doctor if youâre still bleeding as a postmenopausal woman.
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Bleeding After Menopause Does Not Always Mean Cancer Growth
Bleeding after menopause may happen to some women. It may be because of the vagina getting dry and lost its elasticity as the estrogen level is decreasing. But it is not the normal symptom to get bleeding after menopause. So you must consult your doctor immediately. Sometimes the bleeding may happen because of taking birth control medicines, hormone imbalance etc. It may happen because of some non cancerous growth in the uterine.
Its common belief that Bleeding after menopause does mean cancer growth but its not true. But there is possibility of cancer in womb. If there is any abnormal bleeding after menopauses, then you have to check it whether it is happening because of cancer growth. Even if you have smell or pain in vagina, then you have to consult your doctor.
Normally post menopause bleeding will occur due to some other gynecological problems. So you need not fear that there is always a chance of cancer. Mostly the post menopause bleeding is because of hormone imbalance. Women who undertake hormone replacement therapy may experience this problem frequently. Lack of estrogen causes dryness in the lining of the uterine and the blood vessels in uterine breaks down and cause bleeding.
Polyps and fibroids may also cause post menopause bleeding. While polyps causes light bleeding, fibroids causes heavy bleeding that requires treatment immediately. Sometimes any over growth in the uterine lining may also cause bleeding. And 20 % of such growth may be because of cancer.
How Do You Know The Cause Of Postmenopausal Bleeding
- Identifying the cause of the bleeding can include the following:
- Exam by your provider of the vagina and cervix.
- Pap smear to check the cervical cells.
- Ultrasound, usually using a vaginal approach, which may include the use of saline to make it easier to see any uterine polyps.
- Biopsy of the endometrium or uterus. In this procedure, your healthcare provider gently slides a small, straw-like tube into the uterus to collect cells to see if they are abnormal. This is done in the office and can cause come cramping.
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Why You Should See A Gynecologic Oncologist
When postmenopausal bleeding is diagnosed as endometrial cancer, most cases can be cured with a hysterectomy. However, because endometrial cancer can spread into the lymph nodes, many patients also should have a lymph node dissection at the time of hysterectomy. Gynecologic oncologists are specifically trained to perform this procedure when it is indicated.If only a hysterectomy is performed and it turns out the lymph nodes are at risk, were left with difficult decisions. Should the patient start radiation therapy, or should she go back into the operating room to perform the lymph node dissection? Seeing a gynecologic oncologist immediately after diagnosis can avoid these complications, simplifying care and improving the chance of survival.Its not always easy to travel to a gynecologic oncologists office. Dallas-Fort Worth residents are lucky in this respect, as there are a number of us in the area. I have patients who come from several hours away because were the closest available clinic. While making the trip to see a gynecologic oncologist may be inconvenient, its important for your care.
Pelvic Pain A Mass And Weight Loss
Pain in the pelvis, feeling a mass , and losing weight without trying can also be symptoms of endometrial cancer. These symptoms are more common in later stages of the disease. Still, any delay in seeking medical help may allow the disease to progress even further. This lowers the odds of;treatment being successful.
Although any of these symptoms can be caused by things other than cancer, its important to have them checked out by a doctor.
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Postmenopausal Bleeding Is Never Normal
Whether its light spotting or a heavier flow, vaginal bleeding after menopause can signal potential health problems.
It should always be brought up with your provider, said Gina M. Mantia-Smaldone, MD, a gynecologic oncologist at Fox Chase Cancer Center. And the sooner, the better. Rather than waiting for your next planned checkup, give your gynecologist a call quickly to schedule an evaluation.
Treatment Measures For Bleeding After Menopause
Even if the problem of cancer is successfully averted, you should not forget that you lose blood. Its not normal if its severe and frequent. Fortunately, there are many measures to successfully cure this problem. Consider the next possibilities:
- Estrogen administration. You may pass a course of treatment with estrogen pills. Besides, your doctor may appoint vaginal rings or creams.
- Progestin therapy. This measure is taken if you suffer from the thickening of the uterus tissues. Its carried out in the laboratory.
- Hysteroscopy. This one is applied to remove polyps. Besides, it may be applied to handle the problem of the thickening of the uterus tissues.
- Surgery. At times, only surgery can help to remove polyps or the thickened tissues. This process isnt too painful and complex.
- Preparations. In case your blood loss is caused by the ailments transmitted via sex, youll be prescribed one or several preparations. They will be prescribed according to the severity of your problem and your natural tolerance.
Is bleeding after menopause always cancer? Its a good question, which must be asked by every woman who goes through menopause. Always consult certified specialists to receive the right and quick answer. Be cautious and attentive to avoid possible problems to be healthy and live your life to the fullest. If the disease is diagnosed, youll have to pass a hysterectomy. At times, other measures are undertaken .
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When Should I Contact My Doctor
Contact your healthcare provider if you experience vaginal bleeding:
- More than a year after your last menstrual period.
- More than a year after starting hormone replacement therapy .
A note from Cleveland Clinic
Its normal to have irregular vaginal bleeding in the years leading up to menopause. But if you have bleeding more than a year after your last menstrual period, its time to see your healthcare provider. It could be the result of a simple infection or benign growths. But in rare cases, bleeding could be a sign of uterine cancer.
Last reviewed by a Cleveland Clinic medical professional on 05/26/2021.
Bleeding After Menopause: Get It Checked Out
Bleeding after menopause can be disconcerting, but the good news is, more than 90% of the time its not caused by a serious condition, according to a study in JAMA Internal Medicine.;That said, the study also reinforces the idea that postmenopausal bleeding should always be checked out by your doctor to rule out endometrial cancer, a cancer of the uterine lining, says Dr. Ross Berkowitz, William H. Baker Professor of Gynecology at Harvard Medical School. This is because the study also found more than 90% of women who did have endometrial cancer had experienced postmenopausal bleeding. And screening all women who experience bleeding after menopause for endometrial cancer could potentially find as many as 90% of these cancers, which are highly curable if found early.
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What Happens At Your Gp Appointment
The GP should refer you to hospital or a special postmenopausal bleeding clinic. You should not have to wait more than 2 weeks to see a specialist.
What happens at your hospital or clinic appointment
A specialist, who may be a nurse, will offer you tests to help find out what’s causing the bleeding and plan any necessary treatment.
The tests may include:
- a small device being placed in your vagina to scan for any problems
- an examination of your pelvis and vagina a speculum may be inserted into your vagina to hold it open, so the inside of the vagina and the cervix can be seen
- a thin, telescope-like camera being passed up your vagina, through the cervix and into your womb to look for any problems and to take a tissue sample for testing under local or general anaesthetic
- the specialist may press on your tummy and inside your vagina to check for lumps, tenderness or other abnormalities
Its Really A Hemorrhoid
If you see blood on toilet paper or in your toilet bowl, it could actually be rectal bleeding from hemorrhoids. Other possible causes of rectal bleeding include a fissure or cut, a bacterial infection or inflammatory bowel disease. If the source of your bleeding turns out to be rectal, your doctor will likely suggest a stool test and, if it could be more than a hemorrhoid, possibly an imaging test such as a colonoscopy to find the cause.
Every one of the above causes of postmenopausal bleeding is far more common than uterine cancer, so again, if youve seen blood, dont panicbut do see your doctor right away.
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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.
The Reassuring News On Postmenopausal Bleeding
The analysis found that most post-menopausal bleeding is caused by a noncancerous condition, such as vaginal atrophy, uterine fibroids, or polyps. That information doesnt really differ from what doctors have historically thought about the incidence of endometrial cancer and bleeding, says Dr. Berkowitz. But it does finally put solid data behind those figures, which was missing in the past, he says. The researchers who conducted this study were looking for clues about postmenopausal bleeding and how it relates to endometrial cancer.
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Getting To The Bottom Of It
Postmenopausal bleeding can range from light spotting that is pinkish-gray or brown, all the way to a heavy flow, like a regular period. Most of the time, there is no pain with the bleeding. No matter your exact symptoms, youll want to get in touch with your ob-gyn right away if this happens to you.
Any evaluation should start with a detailed conversation, either in person or via telehealth;. Your ob-gyn should ask questions such as:
- When did you go through menopause? The longer its been, the greater cause for concern and the more testing we might need to do.
- Are you taking any new medications? Some drugs, such as blood thinners and some mental health medications, can have vaginal bleeding as a side effect.
- What else is going on with your health? Other medical conditions could be relevant.
A pelvic exam;usually is needed when were talking about unexplained vaginal bleeding. During the exam, your ob-gyn may look at your vagina and cervix and feel the size of your uterus.
The next steps will depend on your age, how long it has been since you reached menopause, and how much bleeding youre experiencing. Your ob-gyn might suggest a pelvic ultrasound;to look at your uterus more closely or a biopsy to take a tissue sample from the lining of your uterus. You might even need both.
Is Postmenopausal Bleeding Normal
No, vaginal bleeding after the menopause is not normal and should always be assessed by a doctor. Although postmenopausal bleeding is not always a sign of something serious and can be caused by several different issues, it is vital to find out what the underlying cause is and seek treatment when necessary.
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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
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.