Bleeding after Menopause

Is Vaginal Bleeding After Menopause A Cause For Concern?

Most women approaching the menopause will have got used to erratic periods and unusual bleeding, but once you have experienced twelve months without a period any vaginal bleeding should be considered abnormal and a reason to consult your doctor.

Of course there are always exceptions to the twelve month rule, and it may be that what you see as post menopause bleeding is actually just a couple of extra periods, but it is still vital to check this with your doctor, especially of you have more than one episode of bleeding within a short time period.

It is crucial for women that are approaching the menopause to keep a record of their menstrual cycle and any bleeds, so they can identify when they have had twelve period free months. This means that any post menopause symptoms such as vaginal bleeding can be recognised and dealt with quickly.

The causes of bleeding after menopause

There are a number of possible explanations for vaginal bleeding after menopause, some of which are very normal and relatively harmless, and some of which are much more worrying.

The most common reason for post menopause bleeding is that the tissue which lines the vagina becomes very thin due to a deficiency of oestrogen. This condition is known as atrophic vaginitis. This leads to swelling and inflammation of the vagina and uterine tract, which can cause abnormal bleeding. In this case the bleeding can be made worse by sexual intercourse, and is often further aggravated by the use of tampons.

Other medical factors that may cause post menopause bleeding include vaginal infections, uterine fibroids and polyps. Although these will require prompt treatment, they should not be a cause for concern. Some women also experience bleeding after menopause because they have a hormone imbalance, or are using hormone treatments such as Hormone Replacement Therapy or birth control pills.

The worst case scenario for vaginal bleeding after menopause is that it can signify endometrial cancer or cancer of the womb. This is true for around 10% of women that experience post menopause bleeding. If this is the case the sooner your doctor can diagnose this condition and you can begin treatment, the greater your chances of dealing with it effectively. Vaginal bleeding after menopause is an indicator of endometrial cancer in its very early stages and the chances of curing it at this stage are excellent.

Recommended tests for vaginal bleeding after menopause

At your initial consultation your doctor may perform blood tests and a pelvic examination. However, if you are experiencing post menopause bleeding, your doctor will probably refer you to a gynaecologist for specialized tests. These tests may include:

An ultrasound scan

A biopsy of the womb lining

A hysteroscopy to examine the inside of the womb telescopically

Vaginal bleeding after menopause can be a really worrying experience, and going for tests as early as possible can put your mind at rest if you find it does not signify anything serious. If the tests do show a serious cause for your post menopause bleeding, the sooner you begin treatment the more effective it will be.

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