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Postmenopausal Periods

Once a woman enters menopause, she will no longer have menstrual cycles. This is especially true of women in post-menopause. Even though bleeding can take place post-menopause, it is due to other causes and never attributed to a period. This bleeding can be sporadic and spotty, light or heavy like a menstrual cycle.

  1. What is Post-menopause?

    • There are three stages of menopause: perimenopause, menopause and post-menopause. Perimenopause is the two to eight year transitioning period right before menopause begins. In this stage the hormone estrogen, which is responsible for regulating your menstrual cycle, will start to gradually decrease. The second stage, menopause, begins when the female hormone estrogen has declined significantly enough to stop menstruation. Post-menopause is the final stage of menopause, signaling its beginning 12 months after your first missed menstrual cycle. This usually takes place between the ages of 45 and 55.

    Identification

    • Some women know they are in post-menopause, when their menstrual flow comes to an end suddenly. More commonly the changes that are associated with post-menopause happen gradually. The most common symptoms are heart pounding or racing, hot flashes, night sweats, insomnia and skin flushing. Some other less common symptoms may include decreased sex drive, mood swings, vaginal dryness, spotting or light bleeding (usually accompanying vaginal dryness), urine leakage and an increase in vaginal infections.

    Causes of Bleeding Post-Menopause

    • Causes of bleeding post-menopause are attributed to three areas: the uterus, ovaries and vagina. Uterine bleeding is usually caused by the development of uterine polyps. These are small bulb-like growths that grow from and attach to the uterine lining inside of the womb. They cause slight bleeding, and may multiply in number, or go away on their own. Causes of bleeding from the ovaries may be due to the development of ovarian cysts. These cysts form in the ovaries due to an imbalance in the hormone estrogen. The vaginal lining becoming thin causes the blood vessels housed in it to weaken and break causing bleeding from the vagina. This is called vaginal atrophy.

    Treatments

    • The first treatment you may be offered is HRT, or hormone replacement therapy. Hormone replacement therapy regulates the hormonal imbalance caused by the drop in estrogen. It is given as a 28-day pill supply , or a vaginal cream to increase the levels of estrogen, and progesterone (if you still have ovaries) which will minimize discomforts such as hot flashes, night sweats and lower instances of bleeding from conditions such as vaginal atrophy, ovarian cysts and uterine polyps.

    Considerations

    • Even though bleeding post-menopause occurs, this is in no way normal. All instances of bleeding in this stage of menopause are to be considered abnormal until the cause is properly investigated. In some rare cases, bleeding in post-menopause can signal ovarian, uterine or cervical cancer.

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