Menopause is when a person who menstruates has not had a menstrual period for an entire year.
It typically occurs between ages 45 and 55.
As such, vaginal bleeding after menopause requires prompt medical attention from a healthcare provider.
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This article reviews the symptoms, causes, and treatment of postmenopausal bleeding.
Medications linked to postmenopausal bleeding and risk factors for endometrial cancer are also discussed.
Any key in warrants a medical evaluation.
These include:
Causes of Bleeding After Menopause
There are numerous possible causes of bleeding after menopause.
With endometrial cancer, cells within the inner lining of the uterus grow abnormally and uncontrollably.
Other possible causes of postmenopausal bleeding include:
What Medications Are Linked to Postmenopausal Bleeding?
Estrogen is the hormone that eases the symptoms of menopause, especiallyhot flashesor vaginal dryness.
Progestin (a hormone similar toprogesterone) is needed to prevent endometrial cancer in people with a uterus.
Without progestin, estrogen can lead to uterine tissue overgrowth.
APap smearwill also be performed to check for cervical cancer.
Uterine Evaluation
In all cases of postmenopausal bleeding, it’s crucial to evaluate the uterus.
It can also be used to look for polyps.
The transducer produces sound waves that bounce off the uterus.
A computer then translates the returning sound waves (echoes) as images.
During the biopsy, the provider places a thin, lighted tube through the cervix into the uterus.
The tube has a suction gadget on it that allows a small amount of uterine tissue to be removed.
The uterine tissue sample is then examined under a microscope by a healthcare provider called apathologistfor cancer cells.
Is an Endometrial Biopsy Painful?
Cramping is felt during the tissue removal, but it typically lasts a minute or less.
In some cases, ahysteroscopywithdilation and curettage (D&C)is performed.
Perhaps insufficient tissue is obtained during an endometrial biopsy, or the results are unclear.
Another thin instrument (curette) is used to scrape away tissue from the inner lining of the uterus.
The tissue is then sent to a pathology lab for examination.
Use pads (as you did when you were menstruating) until you see your provider.
Treatment to Stop Postmenopausal Bleeding
The treatment of postmenopausal bleeding depends on the underlying cause.
For example, surgery may be needed to remove noncancerous growths, such as fibroids orpolyps.
Treating endometrial cancer most often requires an operation called atotal hysterectomybilateral salpingo-oophorectomy).
With this surgery, the uterus, fallopian tubes, and ovaries are removed.
Summary
Vaginal bleeding after menopause is not normal and necessitates urgent medical evaluation by an obstetrician-gynecologist.
Symptoms of postmenopausal bleeding may range from spotting to heavy flow.
Vaginal discharge or accompanying symptoms like pelvic pressure may also occur.
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