Postmenopausal Bleeding

Reclaiming Confidence, Prioritizing Health

After menopause, bleeding is referred to as postmenopausal bleeding. When a woman enters menopause, her monthly menstrual periods stop, and her reproductive hormones start to decline (this usually happens at about age 51). It’s not usual for a woman to experience vaginal bleeding more than a year after her last menstruation. There may be minor (spotting) or severe bleeding.

Endometrial polyps are one example of a benign (noncancerous) gynecological disorder that frequently causes postmenopausal bleeding. However, bleeding after menopause indicates uterine cancer (endometrial cancer) in about 10% of women. The most prevalent kind of reproductive cancer is uterine cancer, which is more prevalent than ovarian or cervical cancer. If you notice any bleeding after menopause, consult your doctor.

What are the causes of postmenopausal bleeding?

Following menopause, the following are the most typical causes of bleeding or spotting:

  • Endometrial or vaginal atrophy (thinned and dried uterine or vaginal lining).
  • Hormone replacement treatment (HRT) uses pills containing estrogen and progesterone to relieve some menopausal symptoms.
  • Endometrial cancer, which affects the uterine lining, or uterine cancer.
  • Endometrial hyperplasia, in which the lining of the uterus thickens excessively, and aberrant cells may be present.
  • Uterine polyps, or uterine growths.
  • Additional factors include:
    • Cervix cancer, also known as cervical cancer.
    • Infection or inflammation of the cervix or uterus is called cervicitis or endometritis.
    • Bleeding from neighboring or nearby places, such as the bladder, the rectum, or the skin of the vulva (outside, close to the vagina).

How is postmenopausal bleeding diagnosed?

The following methods can be used to determine the cause of the bleeding:

  • Examination of the cervix and vagina by your healthcare physician.
  • Inspection of the cervical cells with a pap smear.
  • A saline solution may be used during an ultrasound, often performed using a vaginal approach, to help the doctor see any uterine polyps better.
  • During an endometrial or uterine biopsy, a small, straw-like tube is gently inserted into the uterus to collect cells for examination. This in-office procedure may cause cramping but helps detect any abnormalities accurately.

What are the treatments for postmenopausal bleeding?

The reason for postmenopausal bleeding determines how it should be treated. The most frequent forms of therapy are drugs and surgery. The medications consist of:

  • Most cervix and uterine infections are curable with antibiotics.
  • Estrogen may reduce bleeding brought on by dry vaginal tissue. You can use a lotion, ring, or insertable tablet to deliver estrogen straight to your vagina. A pill or a patch may be used for systemic estrogen therapy. Systemic estrogen therapy refers to the hormone’s distribution throughout the body.
  • A synthetic version of the hormone progesterone is known as progestin. It causes the uterus to shed its lining, which can be used to treat endometrial hyperplasia. Progestin can be given as a pill, injection, cream, or intrauterine device (IUD).

If the condition is worse, you might be required to undergo surgical methods that include –

  • A procedure called hysteroscopy uses a camera to examine your cervix and uterus. To eliminate the polyps or other abnormal growths that might be causing bleeding, your healthcare professional inserts a hysteroscope (a thin, lighted tube) into your vagina. For diagnosis, this can be carried out in the office. Under general anesthesia, hysteroscopy is frequently performed in the operating room to remove growths.
  • A dilation and curettage (D&C) is used to sample the uterus’ lining and contents. Your doctor might combine a D&C with a hysteroscopy. Some forms of endometrial hyperplasia can be treated with a D&C.
  • Your uterus and cervix are removed during a hysterectomy. If you have uterine cancer, you might require a hysterectomy.

You can discuss more about the various methods of uterine removal from your doctor. Some operations require very small cuts or incisions because they are minimally invasive.

Why Choose Giggles Hospitals?

Vaginal bleeding after menopause is a concerning symptom, reported by less than 11% of women. It often indicates an underlying health issue. At Giggles Hospital, known for Best Women And Children Hospital in Kukatpally, we offer comprehensive treatment and care to address and manage such concerns effectively. Visit us at our Gynecologist hospital for personalized attention and expert medical guidance.

Our Doctors

Dr. Batchu Sowdamini

Senior Consultant Obstetrician and Gynaecologist View Profile
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Dr. Radhika Jupally

Gynecologist and Obstetrician View Profile
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Dr. Padmaja S

Gynaecologist and Obstetrician View Profile
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Frequently Asked Questions

The cause is usually benign, but uterine cancer accounts for 1-14% of cases. Therefore, it is essential to seek medical assistance if any postmenopausal bleeding occurs to ensure timely evaluation and appropriate care.

About 4–11% of women experience postmenopausal bleeding, and endometrial cancer accounts for 1–14% of cases.

The most frequent cause is endometrial (uterine) or vaginal atrophy. Low estrogen levels cause the uterine or vaginal lining to thin. However, bleeding could signify a more serious illness, like cancer.

Vaginal bleeding can happen to everyone, particularly during the perimenopause. The period preceding menopause, known as perimenopause, often starts between 40 and 50. It is the stage when a woman's periods and hormone levels begin to alter.

If you spot postmenopausal bleeding, it is advisable to seek immediate medical attention for timely evaluation and appropriate care.