Any type of vaginal bleeding after menopause is a sign to visit our gynecologist. Vaginal bleeding is not normal after you have reached menopause, which is 12 months without a period. If you’re experiencing postmenopausal bleeding, this is typically a symptom of an underlying health conditions, some of which can be serious or life-threatening. Let’s talk about what to do if you noticed postmenopausal bleeding, what to expect at our clinic, and some common causes of vaginal bleeding after menopause.
Any time you experience vaginal bleeding after menopause, it’s important to discuss your symptoms with a women’s health care professional. While there is no reason to panic, you should take abnormal vaginal bleeding seriously, whether you’re experiencing light spotting or heavy flow.
An estimated 4% to 11% of women experience postmenopausal bleeding for one reason or another. Many women mistakenly believe that a little bleeding after menopause is no cause for concern and put off getting healthcare. However, we advise scheduling a gynecological services appointment as soon as possible to talk about your symptoms. While it may be something benign, postmenopausal bleeding can also be a sign of serious conditions like endometrial cancer. It’s better to be safe than sorry, so talk to one of our providers about abnormal bleeding.
It’s understandable that you might be concerned about visiting our gynecologist to talk about postmenopausal bleeding. We realize that knowing what to expect during your appointment can help you feel more prepared and may help you feel better before and during your appointment. If you’re experiencing vaginal bleeding after menopause, our treatment providers may recommend a few things to help with diagnosis. In addition to talking about your symptoms, medical history, and relevant family history, the gynecologist may recommend different exams and procedures to help find the root cause.
If you’re experiencing abnormal vaginal bleeding, our gynecologist will typically perform a pelvic exam. Pelvic exams can help our providers assess the health of your reproductive organs, like the vagina, uterus, cervix, and ovaries. During the exam, our provider may also screen for cervical cancer with a Pap test if you have abnormal vaginal bleeding.
In some cases, our gynecologist may recommend a pelvic ultrasound to get a closer look at your pelvic and to help determine the source of your postmenopausal bleeding. This ultrasound may be abdominal or it may be transvaginal. Transvaginal ultrasounds use a thin imaging “wand” placed inside the vagina to get more detailed pictures of your pelvic organs.
While less common, sometimes our doctors may recommend a diagnostic surgery called a hysteroscopy. This procedure allows the doctor to look inside your uterus with a small camera to look for potential causes of postmenopausal bleeding. During the procedure, the doctor may also take a tissue sample to send to the lab for testing to help diagnose the source of your abnormal vaginal bleeding.
There may be many causes of your postmenopausal bleeding. Some of these causes are more serious than others. Visiting our women’s health clinic can help identify underlying causes of your postmenopausal vaginal bleeding and help determine a course of treatment to help relieve your symptoms.
Polyps are small, noncancerous growths. If you’re suffering from vaginal bleeding after menopause, polyps in the uterus or cervix may be to blame. Polyps can easily become irritated and bleed, which can lead to spotting or even heavy vaginal bleeding. Uterine and cervical polyps are pretty common and are unlikely to become malignant, but when they cause symptoms like vaginal bleeding, generally gynecologists recommend removing them with a surgical procedure.
Low estrogen levels during menopause can cause vaginal atrophy, which is where the skin becomes thin and dry. Vaginal atrophy can make the vagina more delicate and more prone to tears which can lead to vaginal bleeding. For instance, if you experience vaginal bleeding after sex, it may be due to friction. If this is the cause of your postmenopausal bleeding, our treatment providers may recommend vaginal moisturizers, vaginal estrogen, or lubricants to help.
In some cases, you may experience endometrial thickening after menopause that causes vaginal bleeding. This is called endometrial hyperplasia and while it is not cancer, it can increase your risk for endometrial or uterine cancer. Depending on your risk factors, our gynecologist may recommend taking progesterone to thin out your uterine lining. For women with higher risks for cancer, you may consider a hysterectomy as treatment.
Certain medications can also cause vaginal bleeding as a side effect. For instance, some women experience postmenopausal bleeding when taking blood thinners. Postmenopausal women taking hormone replacement therapy can experience vaginal bleeding as a side effect for the first six months of treatment. If you’re experiencing bleeding after menopause due to medications, we may explore changing your medications or recommend closely monitoring your symptoms to see if they change or get worse to determine if you may benefit from changing medications.
While rarer, endometrial infections can cause inflammation and vaginal bleeding after menopause. Doctors will generally prescribe antibiotics to help treat bacterial uterine infections. After treatment, your symptoms such as abnormal vaginal bleeding or discharge should improve.
Another rare cause of postmenopausal bleeding are sexually transmitted infections. Infections like chlamydia or gonorrhea can cause inflammation that may lead to abnormal vaginal bleeding. In these cases, treating the STI generally stops the postmenopausal bleeding.
While it’s rare, postmenopausal bleeding can be a sign of endometrial cancer. Endometrial cancer is a type of cancer that begins in the lining of the uterus. About 10% of women who experience postmenopausal bleeding have endometrial cancer. However, an estimated 90% of women with endometrial cancer experience postmenopausal vaginal bleeding. Therefore, while endometrial cancer isn’t a common cause of postmenopausal bleeding, it can be an early warning sign of endometrial cancer. When caught early, the five-year survival rate is approximately 95%. In later stages, the survival rate is much lower. Because of the seriousness of endometrial cancer, most doctors recommend visiting a gynecologist to talk about postmenopausal bleeding and any other symptoms you’re experiencing.
Our health professionals at HerKare are here to empower you to take control of your health. We provide total women’s health care for every stage of life. Whether you need preventative care or are experiencing concerning symptoms, we offer quality care in our warm, welcoming clinics. As a clinic owned and operated by women for women, we are here to provide health care that suits your lifestyle. Make an appointment at one of our clinics today.