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 Changes To Expect As You Age
As you get older, your estrogen levels decrease, causing an imbalance in your pH levels.
But, when hormones change during menopause, you may experience changes to how your vagina feels and smells. This includes:
Vaginal irritation. Itching and burning in your vagina can happen because of all the hormonal changes your body is going through. To relieve this discomfort, you can try vaginal lubricants and creams, estrogen cream, and natural oils like jojoba or coconut.
Dryness. This can happen when your vaginal secretions are decreased. It can also make sexual intercourse painful or uncomfortable. You can ease these symptoms with lubricants and gels.
Inflammation. This can cause infection or pain when urinating. If you have an infection, you may notice an overwhelming unpleasant vaginal odor. You may need to see a gynecologist to get antibiotics for your infection.
Discharge with bad odor. This odor may seem different and unpleasant to you. This happens when your vaginal alkalinity increases. A changing pH level in your vagina is normal during and after menopause.
If you have concerns about your changing vaginal smell or overall health, its best to consult with your gynecologist. They can help guide you through these changes and prescribe products that can ease your symptoms.
What Can Cause Vaginal Spotting 10 Years After Menopause
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How K Health Can Help
If youre worried about the color of your discharge, talk to a doctor. Did you know you can get affordable primary care with the K Health app? , explore conditions and treatments, and if needed text with a doctor in minutes. K Healths AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Postmenopausal Bleeding: An Overview
During perimenopause , your menstrual cycles and periods gradually come to an end. The average length of perimenopause is four years and, during that time, your period can become irregular and there can be irregular bleeding between periods.
Just as periods maybe started out irregularly when you went through the changes of puberty, so they become irregular as you go through the changes of perimenopause and menopause.
Because of this gradual change, many individuals are unsure when perimenopause ends and menopause begins. In medical terms, menopause is confirmed 12 months after your last period.
Bleeding after this point is called post-menopausal bleeding and it is considered abnormal bleeding.
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Why Is My Period Blood Sometimes Brown
Brown blood can look alarming if youre expecting it to be you know, bright red. But if youve ever looked at a wound or cut thats a few days old, you can see that the blood has changed to a dark brown color. This is due to a process called oxidation, where oxygen binds with hemoglobin . This changes the color of old blood from red to brown. So, if your menstrual blood takes a few extra days to exit your vagina, it might be brown by the time you see it.
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.
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What Does Healthy Discharge Look Like
Vaginal discharge varies from woman to woman and at different times of life.
Generally speaking, healthy discharge is white, cream, or clear. Its not too thick and can even be a little watery. It doesnt have a strong odor and doesnt cause irritation.
You can have so little that you dont even notice it until you see it on your underwear. Or you can have so much that you need a panty liner on some days. Both are within the normal range.
The color of your discharge can be a clue that theres something wrong:
- Thick white discharge with the consistency of cottage cheese: This could signal a yeast infection.
- Grayish discharge: This could be due to a bacterial infection.
- Greenish-yellow discharge: This could be a symptom of desquamative inflammatory vaginitis, vaginal atrophy, or trichomoniasis.
- Pink or brown discharge: Pink or brown discharge probably contains blood. If youve gone 12 months without a period, you shouldnt be seeing blood in your discharge. This could be a sign that theres an abnormality of the uterus. It can also be a symptom of cancer.
Here are some more signs that your discharge may not be normal:
- It has an unpleasant odor.
- It is irritating your vagina or vulva.
- Its more than a panty liner can handle.
- You have other unpleasant symptoms, such as redness, burning, or painful intercourse.
You probably noticed changes in discharge during perimenopause. There are several reasons you might have vaginal discharge as you reach menopause.
What Are Some Symptoms Of Uterine Cancer
Uterine cancer usually occurs after menopause, typically between the ages of 60 and 70. It also may occur around the time that menopause begins. Abnormal vaginal bleeding is the most common symptom of uterine cancer. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Women should not assume that abnormal vaginal bleeding is part of menopause. A woman should see her doctor if she has any of the following symptoms:
- unusual vaginal bleeding or discharge not related to menstruation, most commonly postmenopausal bleeding
- thin white or clear vaginal discharge after menopause
- extremely long, heavy or frequent episodes of vaginal bleeding after age 40
- difficult or painful urination
- pain during intercourse
- pain in the pelvic area
These symptoms can be caused by cancer or other less serious conditions. Most often they are not cancer, but only a doctor can tell for sure.
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Is Brown Discharge A Cause For Concern
Since the color brown or a brownish hue is not inherently troublesome, then, how concerned do you need to be about brown vaginal discharge after your period?
Well, just like spotting more generally, brown discharge can have a number of causes. Some brown discharge is not considered itself abnormal or troublesome BUT, it really depends on the cause and other symptoms you might experience in conjunction with brown discharge.
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 .
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How Is Uterine Cancer Diagnosed
The ideal method for screening asymptomatic women has not yet been devised. If a woman has symptoms that suggest uterine cancer, her doctor may check general signs of health and may order blood and urine tests. The doctor also may perform one or more of the following exams or tests:
- Pelvic exam – the doctor checks the vagina, uterus, bladder and rectum for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.
- Pap test – the doctor collects cells from the cervix and upper vagina. Because uterine cancer begins inside the uterus, it does not usually show up on a Pap test. However, postmenopausal women with endometrial cells on a Pap, particularly if they are atypical, need further evaluation.
- Transvaginal ultrasound – the doctor inserts an instrument into the vagina which aims high-frequency sound waves at the uterus. The pattern of the echoes creates a picture. If the endometrium looks too thick, the doctor can do a biopsy.
- Biopsy – the doctor removes a sample of tissue from the uterine lining. This usually can be done in the doctor’s office.
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
- 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.
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Prevention Of Bleeding After Menopause
In order to prevent bleeding after menopause, the best way is to reduce the risk factors that lead to it. The other preventive methods are:
- Use of pads and regular change of pads during menstruation which reduce the chances of infection.
- Safe and hygienic sexual intercourse and use of condoms to avoid sexually transmitted diseases that can cause bleeding after menopause
- Constantly watching over vaginal dryness and maintaining accurate pH levels
- Maintaining a healthy body to avoid obesity by exercise and healthy diet
- Regular checkups with gynecologists to ensure a healthy uterus
- Treatment for Postmenopausal bleeding should be done early to prevent cancer.
Can I Wait And See If It Happens Again Before Going To My Doc
Dr. Jessie: Please dont wait! It is very likely that your bleeding is nothing to worry about and just a nuisance, but occasionally it can be a sign of something more serious. It is always worth a check-up!
If youre experiencing post-menopausal bleeding, please follow Dr. Jessies advice and schedule an appointment right away. If you dont have an ob/gyn, you book a virtual appointment at Gennev Telehealth. If youve dealt with PMB, what caused it and how did you deal with it? Please share with the community: leave us a comment below, or talk to us on our or in Midlife & Menopause Solutions, our closed Facebook group.
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Mayo Clinic Q And A: Spotting After Menopause
DEAR MAYO CLINIC: I am 52 and had recently gone 10 months without a period, so I had assumed I was postmenopausal. But, over the past few months, Ive had light spotting. Does this mean Im not past menopause? Do I need to see my health care provider about this?
ANSWER: Its possible that you havent reached menopause yet. Clinically, menopause is defined as going without a period for one year. At 10 months, you dont quite meet that threshold. But its also possible that you are postmenopausal, and the bleeding is a result of something else. It would be a good idea to make an appointment to see your health care provider and check your condition.
Menopause is the natural process that marks the end of a womans reproductive years when menstrual cycles stop. It typically happens during the 40s or 50s, with the average age of menopause in the U.S. at 51.
Skipping periods as you approach menopause a stage sometimes called perimenopause is common and expected. During that time, menstrual periods often will skip a month and return, or skip several months and then start monthly cycles again for a few months. Periods also tend to happen on shorter cycles during perimenopause, so they may be closer together than is typical for you.
Bleeding after menopause is not normal, and it must be evaluated by a health care provider. Postmenopausal bleeding can have various causes.
Diagnosis Of The Cause Of Spotting After Menopause
To accurately diagnose the cause of brown discharge/spotting after menopause, the doctor would enquire about the patients medical history and the medications which they are currently taking. The gynaecologist may also physically examine the patients pelvis or take a swab to test for infections and other conditions. Other tests which can be recommended to diagnose the cause of spotting after menopause include: pelvic ultrasound, Pap smear, blood test, dilation and curettage .
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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.
Is Spotting Between Periods Normal
Is spotting normal during perimenopause? If you observe small amounts of blood on your underwear between cycles , its considered spotting.
Aside from hormonal changes, perimenopause spotting is also the direct result of endometrial buildup. It happens either before your period starts or near the end of it. If youre spotting between periods, however, it might be an indication of hormonal imbalance and should be discussed with your doctor.
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What Are The Causes Of Spotting After Menopause
Women can experience itching, burning, and off-coloured discharge more regularly than what they did before entered menopause. Brown spotting after menopause is specifically a sign of blood mixing into the discharge. While fresh blood is red, it turns brown or black as it gets oxidized and leaves the vagina. The colour can be lighter or mixed with other colours if the woman is suffering from an infection, like yeast infection. Some of the common potential causes of brown spotting after menopause are:
Is Brown Discharge Normal
Brown discharge is extremely normal and should not cause you any alarm in most cases.
If the bleeding is confined to the beginning or end of your period, its most likely due to the slowing of your menstrual flow the blood takes more time to get from the cervix to your pad or tampon, so it may oxidize in the meantime.
If you experience brown spotting between periods while using hormonal birth control, its most likely a side effect. Talk to your doctor if you become concerned, but know that it is probably nothing to worry about.
If you are trying to conceive and have brown discharge after ovulation, it may be a good sign! Brown discharge could be due to implantation bleeding. Take a pregnancy test on the first day of your expected period to make sure.
Rarely, brown discharge may signify a problem with the reproductive tract. Visit your doctor if you have concerns about brown discharge. It never hurts to be safe.
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Post Menopausal Brown Discharge
Hello everyone. I am 2+ years post menopausal and have had some slight brown discharge/staining and a little bit of cramping. U/A showed my uterus too thick at 9mm with increased vascularity and heterogeneity. Gyno has immediately referred me to Gyn Oncologist – I have a consultation in a few days then likely a D& C. I’m terrified. Any others with the same experience?
4 likes, 92 replies
Posted 4 years ago
Hi Krayne, yes, lots of ladies here have had the same. I had a biopsy under GA about two years ago, very quick easy procedure, rapid recovery, was back at work the next day. All was normal. Had a second episode not so long ago, almost like a period that didnt happen. Agreed with GP just to keep an eye on it. Please try not to worry. I know thats easy to say. I was told my thickened uterus was normal for my stage of menopause. The spotting of blood was like a period. I think we go through so many changes, we almost lose control and our bodies dont behave or respond as before. Its like little surges of hormones causing the body to do funny things. The day I was in hospital, there were 6 of us having the same thing. One lady had had a sudden onset of very heavy bleeding, and I dont think the news was good. The rest of us went on our merry way thinking how lucky we were. Hope you can have it done soon and be a peace. Take care. Xx