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Is It Normal To Bleed Years After Menopause

How Is It Diagnosed

Menopause & You: Bleeding After Menopause

To find the cause of your bleeding, the doctor will do a physical exam and review your medical history. You may need one or more of the following tests:

Transvaginal ultrasound: This image helps your doctor check for growths and look at the thickness of your endometrium. Theyâll place a small probe into your vagina. It sends off sound waves to create a picture of the inside of your body.

Endometrial biopsy: The doctor uses a thin tube to take a small sample of the tissue that lines your uterus. Theyâll send it to a lab where scientists will look for anything unusual, like an infection or cancerous cells.

Sonohysterography: Your doctor may use this test to measure the size of a polyp. Theyâll put a saltwater solution inside your uterus to create a clearer ultrasound image.

Hysteroscopy: When the doctor needs to look inside your uterus, theyâll use a hysteroscope. This thin, lighted tube has a camera on one end.

D&C : During this procedure, the doctor opens your cervix. They use a thin tool to scrape or suck a sample of the uterus lining. They send this to a lab that will check for polyps, cancer, or a thickening of the uterine lining .

Ultrasound and biopsy are usually done in your doctorâs office. Hysteroscopy and D&C require anesthesia on one part of or your whole body. Youâll either go to a hospital or an outpatient surgical center.

Its Always Disconcerting To Have Unexpected Vaginal Bleeding But Its Particularly Unsettling When It Occurs Years After Your Uterus And Ovaries Have Closed For Business And You No Longer Possess A Pad Or A Tampon Its Not Just About Making The Midnight Run For Sanitary Products Its That Stomach

Its always disconcerting to have unexpected vaginal bleeding, but its particularly unsettling when it occurs years after your uterus and ovaries have closed for business and you no longer possess a pad or a tampon. Its not just about making the midnight run for sanitary products, its that stomach-dropping fear that blood equals cancer that causes women to spend hours searching the Internet for reassurance. In spite of the fact that most women imagine the worst, in the majority of cases, postmenopausal bleeding is not an indication of anything serious.

So, if you see red and youre not supposed to; what next?

The first step is to determine where the blood is coming from. Blood on the toilet paper can be coming from the vagina, rectum or bladder, and while it seems as if the source should be obvious, its not always easy to know. When in doubt, put a tampon in . If the tampon stays white but there is blood in the toilet bowl, its most likely coming from the rectum or bladder and a visit to your primary care doctor is in order.;;

So, short of cancer, what causes most postmenopausal bleeding?

A bloody vaginal discharge is commonly due to dryness and thinning of vaginal tissue from lack of estrogen. Vaginal infections such as yeast or bacterial vaginosis are another culprit.

Since uterine cancer is usually diagnosed in its early stages; , there is a high cure rate. In fact, the five-year survival for women diagnosed with a Stage I cancer is 96%.;

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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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.

Is It Normal To Bleed After Menopause We Asked A Gynaecologist

Is it normal to bleed after menopause? The reason you ...

Professor Stergios Doumouchtsis, a consultant obstetrician and gynaecologist, explains everything women should know about post-menopausal bleeding

Bleeding after menopause can be confusing and worrying, which isn’t helped by a lack of open discussion around the subject. This unnecessary taboo causes lots of women to turn to Google for information, advice and support which is why we went straight to an expert for the facts.

One of the most Googled questions is: ‘Is it normal to bleed years after menopause?’ The answer is no. As Professor Stergios Doumouchtsis, a consultant obstetrician and gynaecologist , explains: ‘The menopause is when menstrual periods stop. Women are considered post-menopausal when they have not had a period for one year.’ Any bleeding or spotting after this time is known as post-menopausal bleeding or PMB.

If you are suffering bleeding, spotting or brown discharge after menopause, it is important to contact your GP for a check-up. ‘Although bleeding after menopause is nothing serious in many cases, it can sometimes be a sign of cancer,’ Professor Doumouchtsis explains. This means early detection and treatment will increase the likelihood of a full recovery.

Here, Professor Doumouchtsis talks Red through the common causes of bleeding after menopause, potential treatment for post-menopausal bleeding and the assessment you should expect in your GP’s treatment room.

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It Might Be Worth Seeing A Specialist

Your gynecologist should be able to perform your initial evaluation. But, if he or she suspects that your bleeding might be related to cancer, its important to see a gynecologic oncologist, Mantia-Smaldone said.

Endometrial cancer is usually treated with surgery that includes a hysterectomy, which may be followed by radiation and/or chemotherapy. Because gynecologic oncologists deal with female reproductive cancers every day, they have more experience operating on cancers, staging them correctly, and determining the best course of therapy. And that can add up to a more successful treatment outcome.

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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What Is The Most Common Cause Of Post

‘Bleeding after menopause can be caused by inflammation and thinning of the vaginal skin, or thinning of the lining of the womb. Low oestrogen levels after menopause can result in atrophic changes of the lower genital tract and endometrium . Polyps of the womb or the neck of the womb can also cause vaginal bleeding.

‘Thickening of the lining of the womb is another cause of bleeding. This can be a consequence of high oestrogen levels secondary to HRT, being overweight or other causes.

‘Even if she only has brown discharge and is feeling otherwise well, a doctor’s opinion is needed’

‘Thickening of the lining of the womb is called endometrial hyperplasia and could in some cases progress to cancer. Cancer of the lining of the womb or other gynaecological cancer can present with postmenopausal bleeding.’

‘Depending on the cause of bleeding, there are different treatment options available:

  • The management of cervical polyps involves removal of the polyps and histopathological examination .
  • Atrophy of the vaginal skin, or endometrium, is usually treated by vaginal oestrogen cream or pessaries.
  • Endometrial hyperplasia requires biopsy first and â according to the type of hyperplasia â treatment can vary from doing nothing, to medical treatment , or a hysterectomy for the removal of the womb, ovaries and cervix.
  • In cases of cancer, specialist care usually involves surgery, such as a hysterectomy with additional treatments depending on the stage of the disease.’

Pelvic Pain A Mass And Weight Loss

Is it normal to bleed after menopause? by Dr. Asha Dixit

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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Woman’s Day: Bleeding After Menopause

Womans Day recently interviewed Jessica Chan, MD, assistant professor of OB-GYN at Cedars-Sinai, about bleeding after menopause and why women should never ignore that symptom.;

As the Womans Day;story details, transitioning out of menopause comes with uncomfortable yet common side effects like hot flashes, mood swings and weight gain. But, if your body is suddenly experiencing period-like bleeding after menopause, its time to call your doctor’s office and make an appointment.;

Menopause is considered official when a women does not have a;menstrual period for one year. Typically, women enter menopause around 51 years of age, but it can range from as young as 40;to 58 years old. And before menopause begins, most women experience changes in their menstrual cycle.;

During this transitionary time, your bleeding pattern may start to change due to some wild fluctuations in your hormone levels, Chan told Womans Day. At first, you usually have a shortening of the cycle. Then you may have a change in bleeding pattern. It can be lighter. Then theres a lengthening of the cycle. You may skip some periods;before you stop altogether.

But If bleeding occurs after menopause, doctors need to rule out other conditions. Post-menopausal bleeding can be a symptom of endometerial cancer — also called uterine cancer. About 10% of postmenopausal bleeding experience is due to cancer, the Woman’s Day article states.;

Read the complete story here.

Should You See A Doctor If You’re Bleeding After Menopause

‘Yes, if a woman has an episode of postmenopausal bleeding, she should see her doctor for an assessment. This includes a pelvic gynaecological examination, a vaginal ultrasound and a hysteroscopy if indicated. Even if there is only spotting or brown dischargeâ or she is not sure and is feeling otherwise well â a doctorâs review is needed.’

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Can Fibroids Cause Bleeding After Menopause

Dr. Jessie: Yes, although this is unusual. Most fibroids shrink after menopause and become less symptomatic than they were prior to menopause.

Fibroids that are pushing in to the cavity of the uterus can certainly cause post-menopausal bleeding, but I usually see this in patients who are in their early 50s; they think they are not menopausal because they continue to bleed, but the bleeding is actually coming from the fibroid and not a hormonal cycle.

I dont usually see bleeding from fibroids starting up when a woman is already well in to menopause. If you know you have fibroids and are having bleeding after menopause, I would definitely recommend a visit to your doctor rather than writing the symptoms off as coming from the fibroids. Very rarely, women can develop a fibroid-related uterine cancer called a sarcoma.

Treatment Measures For Bleeding After Menopause

Is it normal to bleed after menopause? The reason you ...

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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What Causes Uterine Cancer Vs Fibroids

Uterine Cancer

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.

Uterine Fibroids

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

Prolonged And Heavy Bleeding During Menopause Is Common

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ANN ARBORWomen going through menopause most likely think of it as the time for an end to predictable monthly periods. Researchers at the University of Michigan say its normal, however, for the majority of them to experience an increase in the amount and duration of bleeding episodes, which may occur at various times throughout the menopausal transition.

The researchers from the U-M School of Public Health and U-M Health System offer the first long-term study of bleeding patterns in women of multiple race/ethnicities who were going through menopause. They say the results could impact patient care and alleviate undue concern about what to expect during this life stage that can last anywhere from 2-to-10 years.

Sioban Harlow

For most women in their 30s, menstrual periods are highly predictable. With the onset of the menopausal transition in their 40s, womens menstrual periods can change dramatically. These dramatic changes can be disconcerting and often provoke questions about whether something is wrong, said Sioban Harlow, U-M professor of epidemiology.

Women need more descriptive information about the bleeding changes they can expect. We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.

The study, Menstruation and the Menopausal Transition, is reported in the current issue of BJOG: An International Journal of Obstetrics and Gynaecology.

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What Treatments Are Available To Help With Postmenopausal Bleeding

The treatments for bleeding after menopause vary depending on whatâs causing the issue, which is why itâs so important to get the right diagnosis.

  • Doctors can remove polyps using a minimally invasive procedure called hysteroscopy.
  • Medications and hormone replacement therapy can treat vaginal and endometrial atrophy.
  • Progesterone hormone therapy is an effective treatment for endometrial hyperplasia.
  • Dilation and curettage can also help with endometrial hyperplasia by removing the excess tissue from inside the uterus.

If cancer is responsible for the abnormal bleeding, your doctor can treat it with a hysterectomy. This surgical procedure involves removing the uterus. In some cases, your doctor may also recommend removing the cervix, fallopian tubes, and ovaries as part of the hysterectomy.

Related: The benefits of progesterone after menopause

Learn more about your postmenopausal health with the Everlywell at-home Postmenopause Test. This postmenopause test can help you to understand if your postmenopausal bleeding is caused by imbalanced hormone levels by allowing you to easily check your estradiol and progesterone levels from the comfort of home.


1. What Is Menopause?. National Institute of Aging. URL. Accessed March 25, 2021.

2. Bleeding after menopause: Is it normal?. Mayo Clinic. URL. Accessed March 25, 2021.

3. Bleeding after menopause: Get it checked out. Harvard Medical School. URL. Accessed March 25, 2021.

What Is Vaginal Bleeding

Menopause and You: Abnormal 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.

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