Is Post-menopausal Bleeding a Cause for Concern?

If you are experiencing any bleeding or spotting after menopause, it's important to be evaluated by your doctor as soon as possible. In most cases, the cause of post-menopausal bleeding is not serious…but it can be.

Menopause is defined by not having a menstrual cycle for a full 12 months. Any bleeding after that time is considered abnormal and should be checked out immediately.

What Could Cause Post-Menopausal Bleeding?

There are many conditions that can cause bleeding after menopause. These are some of the more common:

• Polyps. Usually noncancerous, polyps are growths that either attach to the uterine wall or develop on the endometrium, the lining of the uterus.
• Cervical polyps. These fingerlike growths on the cervix where it opens into the vagina are also usually noncancerous.
• Endometrial thinning. Low estrogen levels can cause the endometrium to become thin and bleed.
• Endometrial thickening. Known as endometrial hyperplasia, a thickened endometrium is most often the result of excess estrogen still circulating without enough progesterone to counter it. Women with endometrial hyperplasia are at increased risk of developing endometrial cancer, so it is important to identify and treat endometrial hyperplasia promptly.
• Endometrial cancer. After menopause, bleeding is the most common sign of endometrial cancer. When diagnosed early, endometrial cancer can be treated successfully. It is the most common cancer of the female reproductive system.
• Other causes. Hormone therapy, infections, some medications, and other types of cancer can also cause bleeding after menopause.

What Are the Treatment Options?

Treatment of post-menopausal bleeding depends on the cause. Surgery might be necessary to remove growths. It is definitely indicated for endometrial cancer. Endometrial thinning or thickening can be treated with medications.

If you notice anything abnormal after menopause, see your health-care provider for prompt testing. Treatments are most effective when the cause is identified early.