Postmenopausal Bleeding: Causes, Diagnosis, and Treatment

Tanuja Bisht

, Health A2Z

A few days back, I was talking to my aunt regarding casual girls problems, somehow our conversation reached to menopause topic. Then my aunt says “I was in my menopause period because I haven’t had a period in two years. But suddenly last month, I got my period again. What’s that? I’m 50 years old.”


I was also shocked after hearing this, but then I researched about it and finally got to know that it was postmenopausal bleeding. Let’s talk about this topic, I am sure few of you have also faced or heard this situation.


Basically, postmenopausal bleeding is the situation similar to menstrual cycle for all the women that are reached to menopause.


In clinical terms, the menopause is the end of menstruation cycle when you reach menopause you haven’t had a period for 12 months.


The vaginal bleeding after menopause is not normal and if you have that problem then you should go and get checked by your doctor.




What is Postmenopausal Bleeding?

Menopause occurs when a woman has not had her period for a year. This event is the result of a natural decline of hormones that a woman will typically have in her 40s or 50s.


If a woman has gone through menopause, she usually does not wait for more bleeding. However, women sometimes have extra vaginal bleeding.


When she went through menopause, the doctors believe that the bleeding is abnormal and a woman should contact her doctor.


Bleeding symptoms may indicate that you need to call your doctor if you are facing bleeding after sexual intercourse or bleeding that is very serious and more than “stained”.


More often, bleeding is not associated with a menstrual problem and may be due to another cause that should be identified.




What are the Causes of Postmenopausal Bleeding?

There are several causes of postmenopausal bleeding including;

Endometrial atrophy:

If the estrogen hormone is no longer present because of menopause, the lining of the endometrium may become thinner. As a result, the lining of the endometrium tends to bleed.


Endometrial hyperplasia:

This condition causes the endometrium to become thicker rather than thinner, resulting in severe or irregular bleeding. The cause of this disease is often the extra estrogen without the hormone progesterone to counter this. Endometrial hyperplasia can sometimes lead to the development of carcinoma of the endometrium.


Endometrial cancer:

It is a cancer of the endometrial lining. It is estimated that 10% of postmenopausal women with uterine bleeding have hemorrhage due to carcinoma of the endometrium.



Polyps are tumors that can develop in the uterine lining. They are usually non-cancerous but can cause unusual or severe bleeding. Polyps can sometimes develop in the cervical canal. When this happens, a woman may have bleeding when she has intercourse.


Other types of causes of postmenopausal bleeding are;

  • Clotting problems
  • Infection of the uterine lining, which is known as endometritis
  • Bleeding from the urinary tract
  • Trauma to the pelvis
  • Thyroid disorders




How the Postmenopausal Bleeding Diagnosis?

There are several test options to diagnose the cause of postmenopausal bleeding include;

  • Dilation and curettage (D&C)
  • Endometrial biopsy
  • Hysteroscopy
  • Sonohysterography
  • Transvaginal ultrasound




What are the Options for Postmenopausal Bleeding Treatment?

Postmenopausal bleeding treatment basically depends upon the conditions including;


Estrogen Therapy:

In this therapy, estrogen hormone is used for the treatment of vaginal and endometrial atrophy. Your doctor may prescribe estrogen in the form of pills, vaginal cream, vaginal ring, and vaginal tablet.


Progestin Therapy:

This man-made version of progesterone hormone is used for the treatment of endometrial hyperplasia. Your doctor may prescribe it in the form of a pill or shot, a vaginal cream, and intrauterine device.



The hysteroscopy procedure helps in the removal of polyps. Doctors also use it to remove the thickened parts of the uterine lining which is caused due to endometrial hyperplasia. In this process, the doctor inserts a hysteroscope into the vagina and pass a tiny surgical tool through the tube.


Dilation and Curettage (D&C):

In the D&C surgery, the doctor opens the cervix. Then he uses a thin tool to remove all the polyps or thickened areas of the uterine lining which is caused by endometrial hyperplasia.





Although postmenopausal bleeding is not a common problem in women if still anybody faces this problem, she should definitely talk to her doctor and should follow all the medical process.

Till stay happy, stay fit…

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