Bleeding after menopause
Postmenopausal bleeding can occur when a woman has not had a period for a year. Postmenopausal bleeding is when the woman experiences unplanned vaginal bleeding. This can be very confusing and scary for some women, but it is quite common. About 30% of women experience postmenopausal bleeding.
Vaginal bleeding after menopause
During menopause, menstruation becomes irregular and eventually stops altogether. The last menstruation is menopause. Do you lose blood again a year after your last menstruation, menopause? Then we call this vaginal bleeding after menopause.
What are the causes of postmenopausal bleeding?
Postmenopausal bleeding can occur for various reasons:
Reduced estrogen
After menopause, estrogen levels drop. Estrogen is important for the health of the vaginal wall. When estrogen levels drop, the vaginal wall can become thinner, drier, and more fragile. This can lead to bleeding, especially after sex or when wiping.
Subsidence
A prolapse is a condition in which an organ in the pelvis, such as the uterus, bladder, or bowel, falls out of its normal position. A prolapse can irritate and damage the vaginal wall, causing bleeding.
Polyp
A polyp is a benign protrusion of tissue. Polyps can occur in the cervix or in the uterine cavity. If a polyp bleeds, it can lead to blood loss.
Cervical cancer
Cervical cancer is a rare form of cancer that can develop in the lining of the cervix. Postmenopausal bleeding can be an early sign of cervical cancer.
Thin mucous membrane
After menopause, the ovaries stop producing hormones. Estrogen is important for the growth of the uterine lining. When estrogen levels drop, the uterine lining can become thin and fragile. This can lead to bleeding, especially after sex or when wiping.
Menstruation
Some women still get a period after not having had one for more than a year. This is more common in women who have not been in menopause for very long. If the gynaecologist finds no abnormalities during the smear and ultrasound, you have probably had a period after all. In this case, the blood loss is harmless.
Thickened mucous membrane
After menopause, estrogen can be released from fatty tissue. This can stimulate the uterine lining, which can cause blood loss. Usually, this thickened tissue is harmless. Sometimes, the tissue becomes restless and (a precursor to) uterine cancer develops.
Uterine cancer
Uterine cancer is a form of cancer that can develop in the lining or muscle of the uterus. Postmenopausal bleeding can be an early sign of uterine cancer. The risk of cancer is greater in women who are older and/or overweight, have high blood pressure or diabetes.
Fibroids
Fibroids, also known as myomas, are benign growths that can grow in the uterus. Fibroids can cause irregular or heavy bleeding, but they are usually no longer active after menopause.
What should you do if you have bleeding after menopause?
If you have bleeding after menopause, it is important to make an appointment with your GP or gynaecologist. The doctor will examine you to find out the cause of the bleeding. This is done with a smear of the cervix or with an internal ultrasound. Depending on the cause, there are different treatments possible.
When should you have blood loss tested?
When should you contact Women's Healthcare Center to have your blood loss investigated:
- You have vaginal bleeding after menopause
- The blood loss continues
- The bleeding returns
- You have abnormal pink or brown discharge
Prevention
There are a number of things you can do to reduce the risk of postmenopausal bleeding:
- Maintain your weight
- Quit smoking
- Eat enough fiber
- Do pelvic floor exercises regularly
What can we do for you?
Women's Healthcare Center provides expert care and support for women. Our team of specialisten will do everything they can to help you get the right diagnosis and find the best treatment options.
