Bleeding After Menopause: What To Do

Reaching the milestone of menopause was quite an accomplishment. Now, you’re experiencing vaginal bleeding once again. Though it’s not typical, bleeding after menopause doesn’t necessarily indicate a serious problem. Getting it checked out can uncover the cause, help you get it under control and give you peace of mind. 

Defining Postmenopausal Bleeding

Bleeding after menopause can be frustrating. After all, you went through menopause expecting to not deal with menstruation again. Now, you may suspect you didn’t go through the change after all. 

Menopause is defined by experiencing a full year without menstruation. If you did that, you’ve gone through it. Still, postmenopausal bleeding occurs after that period-free year.  

Bleeding after menopause looks different for every woman. You may notice light spotting. Or you may experience the same heavy flow you had in a typical period. Though bleeding after menopause rarely causes pain, it should get checked out by your provider. 

Causes of Bleeding After Menopause

There are several reasons for bleeding after menopause. Some of the most common include: 

• Thickening uterus lining. Following menopause, the lining of the uterus may thicken. In some cases, this thickened uterine lining causes bleeding. 
• Thinning lining and tissue. Hormonal changes can cause vagina and vulva tissue to become thinner. Intercourse can irritate this thinner skin and lead to bleeding. The uterus lining may also thin. Known as endometrial atrophy, this, too, can lead to postmenopausal bleeding. 
• Uterine polyps. These noncancerous growths in the uterus often cause no symptoms. When they do, one of the most common is bleeding. 

In some cases, postmenopausal bleeding can indicate cancer. According to a study published in JAMA Internal Medicine, this is the “presenting sign in more than 90% of postmenopausal women with endometrial cancer.” Despite this statistic, postmenopausal bleeding rarely indicates cancer. It’s usually something else. 

Investigating Your Postmenopausal Bleeding

Women who experience bleeding after menopause should not ignore it. No matter the cause, an appropriate diagnosis allows treatment, if needed, to begin early. Therefore, you should see your provider as soon as the bleeding begins. 

Your appointment begins with a discussion of your symptoms. Your provider will ask about your medical history, current health issues and medications you take. You then undergo a physical examination. During this exam, your provider will inspect your vagina, cervix and uterus.  

If necessary, you may undergo additional testing. Potential screenings include: 

• Pelvic ultrasound. An ultrasound camera gives a visual image of the uterus. Your provider can use this to take a tissue sample for evaluation. 
• Diagnostic hysteroscopy. A tiny camera gives an inside look of your uterus. Cells from the uterus lining are removed for testing. 

Treating Bleeding After Menopause

Treatment depends on the source of your bleeding after menopause. Postmenopausal bleeding caused by thinning vaginal tissue may improve with hormone therapy. Surgery can remove bleeding polyps and stop related symptoms.  

If cancer is present, you’ll need cancer care from a gynecologic oncologist. This expert goes over your treatment options and helps you choose the best for your situation. This may include surgery, radiation oncology, chemotherapy, other therapies or a combination of two or more. 

Get Professional Help

Learn more about perimenopause and menopause and Women’s Health Services at St. Elizabeth. Make an appointment with one of our St. Elizabeth Physicians specialists in Northern Kentucky and Southeastern Indiana for help managing your symptoms.