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What Causes Bleeding After Menopause?

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Imagine this scenario:

You’ve been in menopause for three years, and instead of menstrual cramping and PMS, you seek treatment for the inconvenience of hot flashes and night sweats.  Then one day, you start bleeding again, just like you did when you had your period. You wonder why it is happening and if it’s the indicator of something more serious.

“To be clear, any bleeding after menopause is not normal,” said Dr. Miller. “This is a clear indicator that you need to schedule an appointment with us so we can determine the cause. While most causes of postmenopausal bleeding are not life-threatening, it can be an indicator of serious diseases such as various cancers, including endometrial cancer.”

Causes of Postmenopausal Bleeding

Some of the most common causes of postmenopausal bleeding include:

  • Cancer
    • This includes endometrial, uterine, cervical and vaginal cancers.
    • Ninety percent of women who were diagnosed with endometrial cancer reported postmenopausal bleeding.
  • Uterine polyps
  • Fibroids  
  • Vaginal or endometrial atrophy
    • This occurs when the tissues lining the uterus or vagina start to thin.
  • Uterine infections
  • Certain medications
  • Trauma
  • Problems with the endometrium

Because there are so many potential causes—and some of them are life-threatening—an appointment with one of our doctors is imperative. We can usually schedule an appointment within that same week. 

However, the good news is that the most common causes of postmenopausal bleeding are not cancerous. These causes include vaginal atrophy, uterine fibroids or polyps.

What is vaginal atrophy?

After menopause, your body makes less estrogen. As a result, you may have vaginal atrophy, which is the thinning, drying and inflammation of the vaginal walls. It can cause problems with urination such as:

  • Incontinence
  • Urgency to urinate
  • Burning
  • Recurring urinary tract infections

In addition, vaginal atrophy can make sex painful. Treatments include topical estrogen, vaginal moisturizers and water-based lubricants to make intercourse more comfortable.

What are uterine fibroids?

These tumors, which are almost always benign, develop within the uterine muscle tissue and often don’t cause any symptoms. They are very common, and between 20 and 80 percent will develop fibroids before the age of 50. 

When fibroid tumors do cause symptoms, they include:

  • Painful intercourse
  • Miscarriages
  • Urinary difficulties
  • Longer periods
  • Abdominal or lower back pain

Only 1 in 1,000 fibroids are cancerous.  While there is no one definitive cause for fibroids, researchers believe they can be influenced by hormones or genetics. (The Mayo Clinic). 

What are polyps?

These are growths that occur in the uterine lining. They are usually not cancerous, but they can cause problems such as irregular or painful periods and infertility. 

What should I do if I have bleeding after menopause?

“If you’re experiencing bleeding after menopause, it’s not a reason to panic. However, it is imperative to schedule an appointment as quickly as possible so we can determine the cause,” said Dr. Miller.

Generations of Women Have Trusted Chapel Hill OBGYN

Often, several different diseases present similar symptoms. That’s why it’s so important to have a local gynecologist who understands your medical history and has been a partner in your care. Generations of women have entrusted their care to us for decades. If you’re experiencing any bleeding after menopause, we encourage you to schedule an appointment with us today. 

 

For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.

Sources:

Harvard Medical School. “Postmenopausal Bleeding: Don’t Worry — But Do Call Your Doctor.” Online. 

Mayo Clinic. “Bleeding After Menopause: Is It Normal?” Online.

Mayo Clinic. “Uterine Fibroids.” Online. 

National Cancer Institute. “Study Provides Closer Look at Postmenopausal Bleeding and Endometrial Cancer.” Online. 

 

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