Bleeding after menopause

Postmenopausal bleeding

Menopause is the very last period. Because the final periods can be irregular, menopause is confirmed 12 months after the last period. Any bleeding or spotting after this is postmenopausal bleeding. It is not normal to bleed or spot 12 months or more after the last period.

Postmenopausal bleeding needs to be checked out by a doctor. Mostly, the cause will be something very simple and treatable, but occasionally it is a sign of more serious disease.

Causes of postmenopausal bleeding may include

Thickening of the endometrium, called endometrial hyperplasia

Growths in the cervix or uterus (called polyps) which are usually not cancerous

Thinning and inflammation of the lining of the vagina, atrophic vaginitis

Sometimes postmenopausal bleeding can be due to cancer of the endometrium or cervix.

Treatment of postmenopausal bleeding depends on the cause

Thickening of the endometrium is treated with the hormone progesterone and/or surgery to remove the thickening

Polyps are surgically removed using a hysteroscope

Atrophic vaginitis may be treated by applying the hormone estrogen either as a cream or a tablet to the vaginal lining