Patient education: Bleeding after menopause (The Basics)

What is menopause? — 

This is when monthly periods naturally stop.

In the few years leading up to menopause, it's normal to have changes in your periods. For example, you might have periods less often than usual.

If you have not had a period for 1 full year, you have been through menopause. The average age for this is 51, but it can happen earlier or later. After menopause, vaginal bleeding could be a sign of a health problem.

What can cause bleeding after menopause? — 

There are different possible causes. Examples include:

●Vaginal dryness – Menopause can cause the vagina and tissues near the vagina to become dry and thin. Sometimes, this can cause bleeding. For example, you might notice bleeding after having sex.

●Growths in the uterus called "polyps" – These can sometimes cause bleeding. Most of the time, they are not cancerous.

●Cancer of the uterus or cervix – Cancer is when normal cells change into abnormal cells and grow out of control.

●Hormone therapy – Some menopause symptoms, like hot flashes, can be treated with hormone therapy. This often includes both an estrogen and a hormone called a "progestin." Hormone therapy can cause regular episodes of bleeding, similar to a period.

●Other medicines – Some medicines, such as "blood thinners," can cause bleeding. If you have bleeding that could be related to your medicine, tell your doctor right away. They will check to make sure it is your medicine and not something else that is causing the bleeding.

●Infection of the uterus or cervix

Should I see a doctor or nurse? — 

Yes. If you have new vaginal bleeding after going through menopause, see your doctor or nurse. They will do a pelvic exam and ask you questions.

They can also do tests to help figure out the cause of your bleeding. Tests might include:

●Pap test – This is a test to look at the cervix. It is used to check for signs of cancer.

●Pelvic ultrasound – This uses sound waves to make pictures of the uterus, ovaries, and vagina. It uses a thin wand placed in the vagina.

●Endometrial biopsy – This involves taking a sample of tissue from the lining of the uterus and looking at it under a microscope.

In some cases, doctors do other tests, too.

How is bleeding after menopause treated? — 

It depends on the cause. For example:

●If vaginal dryness is causing bleeding, your doctor might suggest using vaginal lubricant or a vaginal moisturizer. Sometimes, they might prescribe vaginal estrogen. This comes as creams, tablets, or a flexible ring that goes into the vagina.

●If bleeding is related to hormone therapy for menopause symptoms, your doctor might adjust your dose.

●If you have polyps in your uterus, your doctor might remove them with surgery.

●If you do have cancer, your doctor will talk to you about treatment options. This depends on the type of cancer and where it is.

More on this topic

Patient education: Menopause (The Basics)
Patient education: Vaginal dryness (The Basics)
Patient education: Uterine cancer (The Basics)
Patient education: Cervical cancer (The Basics)
Patient education: Hormone therapy for menopause (The Basics)
Patient education: Pelvic exam (The Basics)
Patient education: Pelvic ultrasound (The Basics)
Patient education: Endometrial biopsy (The Basics)
Patient education: How to use vaginal medicines (The Basics)

Patient education: Menopause (Beyond the Basics)
Patient education: Vaginal dryness (Beyond the Basics)
Patient education: Cervical cancer treatment; early-stage cancer (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)