The Reasons for Vaginal Bleeding Post Menopause

Most women enter menopause (the end of menstrual periods) at the age of 52. Prior to entering menopause, a woman may be in a transitional state called perimenopause for up to 10 years. During perimenopause, hormone levels begin to decline and periods become less frequent or regular, until they finally cease. A woman is considered to be postmenopausal when she has not had a period in one year or longer. While irregular vaginal bleeding, resembling menstrual periods, is common during perimenopause, it can be a sign of a medical problem if it occurs after menopause.

Causes of Vaginal Bleeding

• The American College of Obstetricians and Gynecologists cites several potential explanations for post-menopausal irregular vaginal bleeding. The most common cause of vaginal bleeding following menopause is the atrophying of the uterine lining, called endometrial atrophy. Another possible cause is hormone therapy used to treat symptoms associated with menopause. Benign growths or polyps, called endometerial hyperplasia, may also cause vaginal bleeding. Finally, vaginal bleeding after menopause can be a sign of endometrial cancer.

Hormone Therapy and Vaginal Bleeding

• Many women experience unpleasant symptoms associated with the drop in hormones that occurs during and after menopause. As a result of these symptoms, which include hot flashes and irritability, doctors often prescribe an estrogen/ progesterone supplement. The Oxford Journal of Medicine suggests that this hormone therapy can cause irregular vaginal bleeding in up to half of patients using the treatment. The irregular bleeding usually resolves itself within six months of beginning the hormone therapy.

Endometrial Cancer

• Because vaginal bleeding can also be a symptom of endometrial cancer, it is recommended that you discuss any vaginal bleeding that occurs post menopause with your physician. The American College of Obstetricians and Gynecologists states that endometrial cancer is the cause of post-menopausal vaginal bleeding in approximately one out of every eight women. If caught early, endometrial cancer has a very high cure rate.

Diagnosis

• Diagnosing the reason for the vaginal bleeding is essential to treating it properly. Doctors often begin by taking a medical history and trying to identify risk factors for cancer, including a family or personal history of cancer and/or irregular periods or the presents of untreated benign polyps. A doctor may also do an endometrial biopsy by scraping a small piece of uterine tissue or an ultrasonography (taking a picture of the pelvic walls using sound waves).

Treatment

• Treatment for irregular vaginal bleeding post menopause depends on the cause of the bleeding. If hormone therapy is causing the bleeding, generally no treatment is advised. If the bleeding is caused by a thinning of the uterine lining, estrogen may be prescribed. If the bleeding is caused by a thickening of the uterine lining, progesterone may be prescribed. Polyps may be surgically removed. Finally, for endometrial cancer, you will be referred to an oncologist, who may recommend a hysterectomy or other appropriate treatment.