If you experience vaginal bleeding - however light or brief - a year or more after your final period, then you are suffering from postmenopausal bleeding. While there are a number of reasons why bleeding can happen, most of them not being serious, it is advisable to see your doctor before ruling anything out. Read on to find out six reasons for uterine bleeding after menopause.
Hormone Replacement Therapy (HRT)
Women taking HRT to smooth the menopausal transition may find that a change in the dosage - either to a stronger dose or when gradually weaning off the prescription during postmenopause - comes with similar side effects to natural hormonal changes in the body. The lining of the uterus can be stimulated by these hormones, building up and shedding, resulting in postmenopausal bleeding similar to menstruation.
Commonly known as vaginal dryness, atrophic vaginitis is the result of changes to the lining of the vagina due to reduced levels of estrogen during postmenopause. The vaginal walls become drier, thinner, and less elastic, which can lead to inflammation. This condition is one of the most common causes of uterine bleeding after menopause.
Benign cervical polyps are relatively common in postmenopausal women. These growths of tissue are found on the lower part of the uterus connecting to the cervix, or the cervical canal, which can cause bleeding after menopause. Very rarely are there abnormal, precancerous, or malignant cells in the polyp, and tests can be taken to check for these.
A lack of estrogen not only causes the lining of the vagina to thin, but its deficiency also causes the lining of the uterus to become thinner and the vessels in the lining to break down. This, in turn, results in spontaneous uterine bleeding after menopause or spotting.
This is a condition in which the lining of the uterus becomes too thick, generally because of an accumulated amount of estrogen in the body with too little progesterone to counteract its effects due to HRT. Endometrial hyperplasia is considered a precursor to endometrial cancer, and it is one of the most common causes of postmenopausal bleeding.
Around 10% of women with postmenopausal bleeding have endometrial cancer. In almost all of these cancer cases, bleeding is the first sign. If the cancer is revealed and treated early, it is commonly curable. This is one of the reasons why it is important for women who have passed menopause to see their physician if they experience any bleeding.
Postmenopausal bleeding is not normal and should be evaluated by your doctor. He or she may also recommend that you lead a healthy lifestyle to allay any further postmenopause symptoms experienced. This includes an optimized diet, wholesome habits, and the smart use of alternative medicine. Learn more about postmenopause treatments so you can have an improved quality of life into your twilight years.
- Harvard Health Publishing. (2011). Abnormal uterine bleeding in peri- and postmenopausal women. Retrieved March 20, 2019, from https://www.health.harvard.edu/womens-health/abnormal-uterine-bleeding-in-peri-and-postmenopausal-women
- Mayo Clinic. (2018). Bleeding after menopause: Is it normal? Retrieved March 20, 2019, from https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/bleeding-after-menopause/faq-20058396
- Newell, S. & Overton, C. (2012). Postmenopausal bleeding should be referred urgently. Practitioner, 256(1749), 13-15. Retrieved March 20, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/22662514
- NHS. (2017). Postmenopausal bleeding. Retrieved March 20, 2019, from https://www.nhs.uk/conditions/post-menopausal-bleeding/
- The Royal Women's Hospital. (n.d.). Bleeding after menopause. Retrieved March 20, 2019, from https://www.thewomens.org.au/health-information/periods/periods-overview/bleeding-after-menopause
- UT Southwestern Medical Center. (2016). Bleeding after menopause: It's not normal. Retrieved March 20, 2019, from https://utswmed.org/medblog/postmenopausal-bleeding/