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 .
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.
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.
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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.
Symptoms Of Abnormal Uterine Bleeding
Vaginal bleeding between periods is one symptom of abnormal uterine bleeding. Having extremely heavy bleeding during your period can also be considered abnormal uterine bleeding. Very heavy bleeding during a period and/or bleeding that lasts more than 7 days is called menorrhagia. For example, women may bleed enough to soak through 1 or more tampons or sanitary pads every hour.
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Why Do I Have A Sore Clitoris Area In Menopause
The clitoris is a soft small bump at the top of your vaginal opening. Its very sensitive and creates feelings of sexual pleasure if rubbed and touched, which can lead to an orgasm.
In the menopause, your clitoris can get smaller. This is because, like the rest of your vulva, it can get thinner and drier as your oestrogen levels fall. This can affect how your clitoris feels, and sometimes lead to pain or soreness rather than pleasure when its stimulated.
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 cancers 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.
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Postmenopausal Bleeding Is Associated With Cancer
As discussed above, Post-menopause bleeding is not a normal condition to experience. Your body is definitely trying to tell you something really serious about your health. To start with it can be a warning sign of cancer. Yes, according to medical studies, post-menstrual bleeding may be caused by Uterine Cancer.
Perimenopause Bleeding: Symptoms And Treatment
Menopause occurs once youve not had a period for at least one full year. The stage prior to menopause is called perimenopause, a term meaning around menopause. So what is it that triggers perimenopausal bleeding? Major hormonal changes are largely to blame for symptoms, such as night sweats, hot flashes, sleep disturbances, and perimenopausal bleeding. This particular phase could last anywhere from a few months to 10 years.
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.
Postmenstrual Bleeding Treatment Options
Treatment options for postmenopausal bleeding will largely depend on whats causing your symptoms. Estrogen therapy can be used to treat conditions such as vaginal and endometrial atrophy. Progestin therapy, on the other hand, is used to treat endometrial hyperplasia.
Polyps can be removed during a hysteroscopy, or they might require surgery. Cancer and severe cases of endometrial hyperplasia can require a hysterectomy. If youre diagnosed with cancer, your doctor will discuss several options with you, including chemotherapy, radiotherapy, and hormonal treatments.
As with most other conditions, the most important step when it comes to postmenopausal bleeding is to get an early diagnosis. Once you know whats causing your symptoms, you and your doctor will be able to discuss treatment options and decide on the best course of action for your individual case.
Discovering that youre bleeding after menopause can be scary, but in most cases, the underlying condition can be treated with simple therapeutic options. Ensuring your wellbeing and overall health should always be your main concern.
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Your Health Questions Answered
- Answered by: Healthily’s medical teamAnswered: 28/09/2021
Yes, menopause can make you feel weak, shaky and dizzy at times. This can result from various different symptoms that either on their own or combined can affect your health.
For example, night sweats can stop you from sleeping and leave you feeling tired and irritable.
Hot flushes, meanwhile, can make your face, neck or chest feel hot. This feeling can spread to the rest of your body, causing sweating and chest palpitations.
You might also experience mood swings or anxiety, which can sometimes leave you feeling shaky.
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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How Your Doctor Will Investigate Postmenopausal Bleeding
If you do experience unusual or postmenopausal bleeding, make an appointment with your doctor to have the problem investigated, says Dr. Berkowitz. Your doctor will likely recommend an ultrasound, a biopsy, or both. Ultrasound can measure the thickness of the lining inside the uterus. In some women with endometrial cancer, this lining becomes thicker than usual, which alerts doctors to the possibility that it is cancerous. Not all thickened linings mean cancer, though. The ultrasound should be followed by a biopsy, even if the ultrasound doesnt show any thickening of the uterine lining, says Dr. Berkowitz. A biopsy can often be done as an in-office procedure, in which the doctor uses a thin tube with a collection device on the end to gather some uterine cells. The sample is then examined under a microscope to check for cancer or precancerous changes.
Is Postmenopausal Bleeding A Reason To Worry
Menopause is the phase of your life when youre over the age of 45 and havent had a period for a year. It can be a little scary if youve gotten used to not having your period and are unexpectedly bleeding after menopause. However, not all causes of postmenopausal bleeding are serious.
No matter what, make sure to talk to your doctor about your postmenopausal bleeding. Regardless of whats causing your symptoms, youll need to go in for a checkup to get a definitive diagnosis.
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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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Menopause And Vaginal Atrophy Symptoms
Vaginal atrophy is the term for when the walls of your vagina become thinner and drier due to falling oestrogen levels, as described above.
You can get symptoms during perimenopause, menopause and postmenopause, although some people have no symptoms.
Vaginal atrophy symptoms can include:
- urinary tract infections that keep coming back
Why Do Fibroids Bleed After Menopause
Also, certain conditions like pregnancy and menopause.
This is why some women with PCOS are hirsute and others are not. Temporal balding is usually seen after prolonged exposure to androgens.
The 26-year-old “tears as if shes giving birth” every time she has sex, leaving her in complete agony and doctors have absolutely no idea why.
bleeding, discharge and pain during or after.
Do Fibroids Always Shrink After Menopause Jun 14, 2011 · If fibroids shrink by 50% after menopause, what would be an approximate shrinkage of the 20-22 week uterus with multiple fibroids and how long it may take for the symtomps of bulk and pressure to go down? On your web site, you mentioned that it could
Shortly after having.
from excessive bleeding, cramping, bloating and anemia from the bleeding. Endometriosis , fibroids, and the birth.
May 26, 2020 · Why Do I Still Have Uterine Fibroids After Menopause? While many women find relief from their uterine fibroids upon the onset of menopause, this is not necessarily a universal experience, particularly for women who receive hormone replacement therapy as a medical treatment during their peri- or post-menopausal years.
Mitra talks us through whats on the Be Gynae Aware checklist.
Theres no such thing as a period after the menopause, and this should always be investigated, as should bleeding.
Traditionally, GYN issuesincluding contraceptive issues, screening for disease, abnormal bleeding/menstrual concerns, menopause.
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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 females 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 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
- 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.
Treating Post Menopause Bleeding
If you have postmenopausal bleeding it is important to have it investigated.
You will most likely be referred to a gynaecologist who may:
- ask you questions about the history of your health
- examine you
- do a blood test
- look at the inside of your vagina and cervix using special tongs . At the same time, they may take a tiny sample of your cervix for testing .
The kind of treatment you have will depend on what is causing the bleeding.
- Atrophic vaginitis and thinning of the endometrium are usually treated with drugs that work like the hormone oestrogen. These can come as a tablet, vaginal gel or creams, skin patches, or a soft flexible ring which is put inside your vagina and slowly releases the medication.
- Polyps are usually removed with surgery. Depending on their size and location, they may be removed in a day clinic using a local anaesthetic or you may need to go to hospital to have a general anaesthetic.
- Thickening of the endometrium is usually treated with medications that work like the hormone progesterone and/or surgery to remove the thickening.
Before treatment there are a number of tests and investigations your gynaecologist may recommend.
All treatments should be discussed with you so that you know why a particular treatment or test is being done over another.
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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.
Tinnitus Can Be Caused By Hormonal Changes
Tinnitus is commonly called ringing in your ears its when you hear noises that arent caused by sounds coming from the outside world. Its common and not usually something to worry about. It can be triggered by the perimenopause or menopause, due to hormonal imbalances.
Self-care measures may help you cope with tinnitus, including:
Read about self-help techniques from the British Tinnitus Association .
If your tinnitus is affecting your sleep or concentration, or causing anxiety, see a doctor. Some evidence suggests that HRT may help with the management and prevention of tinnitus during menopause.
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Current Testing Practices Supported
Although people tend to think of biopsies as invasive and frightening, an endometrial biopsy is a simple procedure similar to a Pap smear, Dr. Chu explained. Like a Pap smear, it can be done in the doctors office and doesnt require anesthesia.
In their study, the researchers ran simulations in which they estimated how many women with postmenopausal bleeding would need to undergo additional testing to detect one case of endometrial cancer, based on varied levels of risk and different testing strategies. Assuming a 10% risk of endometrial cancer and that women underwent subsequent testing with ultrasound, they estimated that 7 women would need to have a biopsy to find 1 cancer.
Before sending a woman for testing, doctors should ask themselves: If she has postmenopausal bleeding, how high is her risk of cancer?” explained Dr. Wentzensen. “Our estimate of 10% supports the current practice of further evaluating these women.”