Postmenopausal Bleeding

What is postmenopausal bleeding?

Postmenopausal bleeding is bleeding from the vagina after you have been through menopause. Menopause is the time in your life when menstruation stops permanently (when you stop having menstrual periods for at least 12 months in a row). It usually happens between the ages of 45 and 55. Menopause also happens if you have surgery to remove your uterus and ovaries (a hysterectomy).

If you have bleeding after menopause, it is very important to contact your health care provider as soon as possible to find out the cause.

How does it occur?

Postmenopausal bleeding may be caused by:

hormone (estrogen) replacement therapy
hormone problems
atrophy of the vagina, which is thinning and drying of the lining of the vagina
polyps (small growths) in the uterus or on the cervix
hyperplasia (enlarged cells) of the lining of the uterus
infection of the cervix
cancer of the uterus, cervix, or vagina
some types of ovarian tumors
anticoagulants (blood-thinner medicines).

How is it diagnosed?

Your health care provider will ask about your medical history, symptoms, and any medicines you are taking. You will have a physical exam. You may have some tests, such as:

blood tests to check your hormone levels
other blood tests
ultrasound scan
biopsy (removal of a small amount of tissue) from the vagina, cervix, or uterus for lab tests.

Tests you may need that require anesthesia (pain-relieving medicine) are:

hysteroscopy, a procedure in which your health care provider uses an instrument with a light to look inside the uterus for polyps or other possible problems
laparoscopy, a procedure in which your provider uses an instrument with a light to look into your pelvis through a small cut in the skin of your abdomen
D&C, a procedure in which your provider scrapes the inside of the uterus to get tissue, which is sent to the lab for tests.

Some of these tests can be done in your health care provider's office, but some are done in the hospital, especially the tests requiring an anesthetic.

How is it treated?

The treatment depends on the cause of the problem. It may be treated with:

hormones or, if you are taking hormones, an adjustment in your medicine
other medicines
endometrial ablation
dilatation and curettage (D&C)
surgery (for example, your uterus, and possibly your ovaries also, may be removed).

How can I help prevent postmenopausal bleeding?

In most cases there is nothing you can do to prevent postmenopausal bleeding. If you are taking hormones or other medicines, a change in your medicine might stop the bleeding. Remember that any postmenopausal bleeding needs to be reported to your health care provider. Most of the time the bleeding is not caused by cancer, but it must be checked to make sure.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File WOM5266F.HTM Release 9.0/2006