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Is It Possible To Bleed After Menopause

What Can Cause Bleeding After Menopause

Bleeding After Menopause

There can be several causes for vaginal bleeding after menopause, including:

  • inflammation and thinning of the lining of the vagina
  • thinning of the lining of the uterus
  • thickening of the lining of the uterus, often caused by hormone replacement therapy
  • polyps or other abnormalities in the cervix or uterus

What Other Conditions Can Cause Bleeding After Menopause

Some other conditions can cause abnormal uterine bleeding after menopause.

  • Endometrial hyperplasia, or the overgrowth of the cells lining the uterus
  • Infection of the uterine lining
  • Injury or trauma to the pelvic area
  • Certain medications, including hormone therapy and tamoxifen
  • Endometrial cancer, or uterine cancer
  • Cervical cancer

In most cases of postmenopausal bleeding, the cause is harmless. However, medical experts still recommend visiting your doctor to rule out more serious causes of abnormal bleeding, such as endometrial carcinoma.

Preventing Additional Bleeding Events

If you have an episode of postmenopausal bleeding, consider it your wake-up call. Its time to give yourself permission to practice fundamental self-care. Following a few simple steps can help prevent bleeding events in the future.

  • First, call your practitioner and make an appointment for evaluation.
  • Then, take a long look at your lifestyle. Add high quality nutrients, make healthier food choices, and get some exercise every day. Start right away you can do this while you wait for your evaluation results.
  • Finally, if your evaluation shows that its okay, try some progesterone support.

Information is Essential in Dealing with Postmenopausal Bleeding

It can be tempting to ignore an issue if you arent sure whats causing it. But knowing what you are dealing with is far better than not finding out until its too late to do anything about it. Thats why I tell women its essential to report any bleeding that occurs after they have been through menopause. There are so many options for handling the situation, once you know what that situation is! Dont look at surprise bleeding as a threat instead, see it as a warning. Contact your practitioner as soon as possible to be evaluated. Once you do, you can take any of the steps necessary to put you back on a healthy path. Then you can start to live a fulfilling and worry-free life!

Two Years Or More Without A Period

There are also a few women that will go for two years or more and find that they get a period back. This is not really very common. And as far as we’re concerned, once you have not had a period for two years, then that’s…you’re well and truly through the menopause.

So if you get any kind of bleeding, either a proper period, or you just get a little bit of smearing, or you get a little bit of spotting, then it really is important that you just get this checked out by your doctor just to make sure that there isn’t anything else going on.

So I hope this has given you a little bit of a better picture of one of the more puzzling aspects of what can happen to your periods as you approach the menopause.

If any of you have any other questions on this or you’ve had a slightly different combination, then please do get in touch, and I’ll be happy to answer your questions. And I will see you next week for another A.Vogel Talks Menopause.

What Happens When You See Your Doctor


You can visit your primary care doctor or gynecologist for postcoital bleeding. Your doctor will ask questions about your symptoms, such as how long and how heavily youve been bleeding. They may also ask about the color of the blood.

Because your symptoms are related to sexual activity, your doctor may also ask about your sexual history. For example, they might ask if you use condoms or barrier methods regularly or if you have more than one sexual partner.

Depending on your symptoms and sexual history, your doctor could recommend a physical exam. Examining the area may help your doctor find the source of the blood. Postcoital bleeding may come from your vaginal walls, cervix, urethra, or vulva.

To help determine whats causing the bleeding, your doctor might also order tests, such as a pap smear, pregnancy test, and vaginal cultures to look for STIs.

Many hesitate to visit their doctor about a sexual health question if they find pelvic exams uncomfortable. However, seeing your doctor about postcoital bleeding wont necessarily require a pelvic exam.

If youve been worried about postcoital bleeding, seeing your healthcare provider may help put your mind at ease.

Treatment For Bleeding After Menopause

The treatment primarily focuses on stopping the blood flow. It may also provide relief from the symptoms. The treatment depends on the cause of bleeding. Treatment methods for bleeding after menopause include:

  • Surgery: The most used form of treatment is the surgical removal of the excessive lining in the uterus under general anesthesia.
  • Medications: Bleeding after menopause due to endometrial atrophy can be treated by medications, fibrin clots can also be treated via medications. However, the treatment of fibrin clots is not done by medications for patients with history of thromboembolism as it may cause stroke or heart attack.
  • Other Remedies: Other remedies include
  • Using pads instead of tampons to avoid irritation
  • Changing pads frequently to avoid infections
  • Avoiding anti-inflammatory medications or aspirin which can prevent the thinning of blood.

What Is Postmenopausal Bleeding

Postmenopausal bleeding is bleeding that occurs after menopause. Menopause is a stage in a womans life when reproductive hormones drop and her monthly menstrual periods stop. Vaginal bleeding that occurs more than a year after a womans last period isnt normal. The bleeding can be light or heavy.

Postmenopausal bleeding is usually due to benign gynecological conditions such as endometrial polyps. But for about 10% of women, bleeding after menopause is a sign of uterine cancer . Uterine cancer is the most common type of reproductive cancer Talk to your healthcare provider if you experience any bleeding after menopause.

What Are Some Risk Factors For Uterine Cancer

Women who get this disease are more likely than other women to have certain risk factors. A risk factor is something that increases the chance of developing the disease. Risk factors for uterine cancer include:

  • being older than 50 years of age
  • having endometrial hyperplasia an increase in the number of cells in the lining of the uterus
  • using estrogen without progesterone
  • being obese or having related conditions, such as diabetes or high blood pressure
  • using tamoxifen to prevent or treat breast cancer
  • having an inherited form of colorectal cancer
  • having a history of endometrial polyps or other benign growths of the uterine lining
  • never being pregnant or being infertile
  • starting menstruation before age 12
  • starting menopause after age 50

Other risk factors relate to how long a womans body is exposed to estrogen. Women who have no children, begin menstruation at a young age, or enter menopause late in life are exposed to estrogen longer and have a higher risk. The endometrium can be stimulated by the increased estrogen levels related to obesity, liver disease or other sources such as postmenopausal estrogen.

Postmenopausal Bleeding Is Never Normal

4 reasons your periods can come back

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.

When Might I Be Referred To A Gynecologic Oncologist

Usually, youll see a gynecologic oncologist if you have been diagnosed with a serious precancer or a cancer of any of the areas of the gynecological tract, King said.

Diseases treated by gynecologic oncologists include:

If you are told you have one of these cancers, ask to be referred to a gynecologic oncologist.

Most OB/GYNs who have a patient diagnosed with cancer want to send that patient to a specialist, King said. If you have the opportunity to see a gynecologic oncologist, you should.

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.

Causes Of Bleeding During Postmenopause

Postmenopause bleeding may occur in up to 10% of women aged over 55 years. The potential causes of postmenopause bleeding include vaginal atrophy, endometrial hyperplasia, cervical polyps, or a side effect of hormone replacement therapy. The aim of postmenopausal bleeding is to identify a cause and exclude cancer. Here are some causes explained:

Why Your Periods Might Suddenly Come Back

Is it Possible to Have Periods during Postmenopause ...

Many women going through the menopause find that they can go months or even years without a period, only to wake up one day and discover that theyve returned! Today Im exploring why hormones and even diet can cause your periods to return, and when you should go and see your doctor.

Eileen Durward

Can Stress Cause Postmenopausal Bleeding

As we women age, our bodies go through some drastic and remarkable changes. After the childbearing years, the 40s and the 50s, the female body begins to change away from procreation as the production of reproductive hormones naturally begins to decline. This phase of a womans life is called menopause and is signaled by 12 continuous months since the last menstrual cycle.

The average age in the United States for women to start menopause is around 51 years of age. There are three phases of menopause that women typically go through and they are perimenopause , menopause, and then postmenopause .

Many questions surround this phase of female life, and for the purpose of this article, we are going to look at the postmenopause phase and a common question that arises often. 

Other Reasons For Bleeding After Menopause

If the answer to is bleeding after menopause always cancer is negative, you should check other reasons too. Dont leave this matter alone and hope for a miracle. Its necessary to define the reason why you bleed to stop it.

Does bleeding after menopause always mean cancer? Of course, its not always so. Therefore, be aware of other reasons:

  • Polyps. These are specific and malicious growths. Although they arent cancerous, they may induce severe bleeding.
  • Endometrial atrophy. This tissue lines your uterus. One of the adverse reactions of menopause is the lack of estrogen. This leads to the thinning of the tissue that results in blood loss.
  • Endometrial hyperplasia. This problem is the opposite of the previous one. Its characterized by the thickening of the uterus tissues and so, may induce the loss of blood. Moreover, it can confirm the issue of cancer.
  • Vaginal atrophy. Low levels of estrogen also thin the vaginal walls. Thus, the loss of blood is possible too.
  • Ailments of sexual character. Some ailments are transmitted during sex. There are many viruses, such as herpes, which also cause bleeding.
  • Preparations. Another reason why spotting happens is due to certain drugs you may be taking. Be aware of hormonal therapies as well. They may make your tissues thinner.

Make Your Health A Priority

Women are known to focus on their families first and put their own health second. But you cant care for loved ones if youre not healthy yourself. Listen to your body. Alert your doctor to any changes or abnormal issues such as postmenopausal bleeding as soon as possible.Dont stop seeing your general gynecologist for an annual exam when you hit menopause. Just because your reproductive years have ended doesnt mean those body parts go away! Your cancer risk increases as you age, and your gynecologist can screen for the disease and help you manage any conditions caused by hormone changes.If youre experiencing postmenopausal bleeding or have any concerns about your gynecologic health, request an appointment online or by calling 214-645-8300.

Treatment Measures For Bleeding After Menopause

Postmenopausal Bleeding

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 .

How Is It Treated

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.

Can Fibroids Grow After Menopause

Particularly noteworthy are patients with fibroids after menopause. First of all, it should be mentioned that menopause in such cases occurs 1-3 years later than in women without fibroids.

The content of female sex hormones that are produced by the ovaries becomes so low that all proliferative processes normally stop in the body. The menstrual cycle stops, and with it, cyclic hormonal changes. The size of the uterus and ovaries gradually decreases, the endometrium of the uterus becomes thinner and does not grow.

Along with the processes of extinction of the ovaries, uterine fibroids after menopause decrease and disappear. Risk factors for the absence of a decrease in fibroids after menopause are the presence of ovarian cysts and endometrial hyperplasia. If uterine fibroids do not regress to postmenopause and the first 1-2 years of postmenopause, then its further existence is accompanied by the risk of endometrial cancer, ovarian cancer, and uterine sarcoma!

Generations Of Women Have Trusted Chapel Hill Obgyn

Often, several different diseases present similar symptoms. Thats why its so important to have a local gynecologist who understands your medical history and has been a partner in your care. Generations of women have entrusted their care to us for decades. If youre experiencing any bleeding after menopause, we encourage you to schedule an appointment with us today. 

For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.

Harvard Medical School. Postmenopausal Bleeding: Dont Worry But Do Call Your Doctor. Online. 

Mayo Clinic. Bleeding After Menopause: Is It Normal? Online.

What Is Vaginal Bleeding

Endometrial Bleeding After Menopause

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.

What Causes Bleeding After Menopause

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.

How To Use Tamoxifen Citrate

Read the Medication Guide provided by your pharmacist before you start using tamoxifen and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth with or without food, usually once or twice daily for 5 years, or as directed by your doctor. Daily dosages greater than 20 milligrams are usually divided in half and taken twice a day, in the morning and evening, or as directed by your doctor. If you are using the liquid, measure the dose carefully using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment. The duration of treatment to prevent cancer from returning may be between 5 to 10 years, depending on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

If you have breast cancer that has spread to other parts of the body, you may experience increased bone/cancer pain and/or disease flare-up as you start taking tamoxifen. In some cases, this may be a sign of a good response to the medication. Symptoms include increased bone pain, increased tumor size, or even new tumors. These symptoms usually disappear quickly. In any case, report these symptoms right away to your doctor.

Inform your doctor right away if your condition worsens .

Vaginal Or Endometrial Atrophy

As hormone levels decrease during menopause, the vaginal lining or the uterine cells may become thinner. This thinning is called vaginal atrophy or endometrial atrophy.

Vaginal atrophy often causes the vagina to become drier, less flexible, and more susceptible to inflammation or infection than before menopause. Vaginal atrophy may lead to:

  • brown spotting
  • redness
  • bleeding after sex

The vagina may feel continuously uncomfortable, so a woman with these symptoms should speak to a doctor. A doctor may recommend hormone replacement therapy, as well as the use of water-soluble lubricants during sexual activity.

Symptoms Of Postmenopausal Bleeding

5 serious menopause symptoms you shouldnât ignore

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

A doctor may conduct a physical exam and a medical history analysis. They may also conduct a Pap smear as part of a pelvic exam. This can screen for cervical cancer.

Doctors may use other procedures to view the inside of the vagina and the uterus.

Why Am I Bleeding Again Common Causes And Treatments For Postmenopausal Bleeding

Imagine making it through menopause a whole year without a period then suddenly start bleeding again. You may find that surprising, but postmenopausal bleeding happens more often than you might think.

I have many women come to me confused and frightened understandably so. They feel that something serious might be wrong. After all, how could this happen if theyve gone through menopause already?

Heres an important note: if youve had a period within the past year you arent through menopause yet, no matter how infrequently those periods come. But if you begin to spot or get what feels like a period after more than a year with no bleeding, theres no need to panic.

Be sure to see your health care provider as soon as possible to calm your fears about this sudden bleeding. However, as I will go over in this article, quite often there is a reasonable explanation for this postmenopausal bleeding.

This time of life can bring a host of symptoms directly related to lifestyle issues, and postmenopausal bleeding is no exception. Sudden bleeding or spotting is often a message from your body; its asking you to slow down and take a closer look at your life, and how you are taking care of yourself. Lets examine some things that cause bleeding after menopause, and talk about what you should do if it happens to you.

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.

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 .


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