Menopause brings some difficult side effects for many women, but some appreciate the end of their monthly menstrual cycle. 

There are times, however, that women still experience bleeding after menopause. If you have fibroids, you may be wondering if uterine fibroids can cause bleeding after menopause? 

Here’s what you need to know.

What Are Uterine Fibroids?

Let’s start by understanding uterine fibroids. These are growths of the uterus that 

often appear during your childbearing years.¹ Uterine fibroids are not cancer; they almost never turn into cancer; and they are not linked with a higher risk of other types of cancer in the uterus. In more than 99% of fibroid cases, the tumors are not cancerous and do not increase the risk for uterine cancer.²

Also known as myomas, uterine fibroids are actually quite common. In fact, it’s estimated that 20 to 50% of women of reproductive age currently have fibroids, and up to 77% of women will develop fibroids sometime during their childbearing years.²

Fibroids can also vary in number and size, from one to many and from tiny to the size of a grapefruit or larger.¹ Only about one-third of these fibroids are large enough to be detected by a health care provider during a physical exam, so they are often undiagnosed, or found when screening for something else.²

What Are The Symptoms of Uterine Fibroids?

Sometimes fibroids cause no symptoms at all! For those women who do have symptoms, those can vary depending on the size and number of fibroids as well as their location. Fibroids can grow within the muscular wall of the uterus, bulge into the uterine cavity, or form on the outside of the uterus.¹

Here are the most common symptoms of uterine fibroids:¹

• Heavy menstrual bleeding.
• Painful periods.
• Longer or more frequent periods.
• Pelvic pressure or pain.
• Frequent urination or trouble urinating.
• Constipation.
• Pain during sex.

Sometimes large fibroids can cause the stomach to grow, or create pain in the stomach area or lower back. Very rarely, a fibroid can cause sudden, serious pain when it outgrows its blood supply and starts to die.²

Also occurring rarely, a fibroid may burst, which is a serious medical condition that requires emergency care. Those symptoms include acute abdominal pain and a low-grade fever.

What Causes Uterine Fibroids?

The cause of fibroids is not clearly known. Some research suggests that each tumor develops from an abnormal muscle cell in the uterus. This cell then “feeds” on the hormone estrogen, and the cell multiplies. It seems that the estrogen hormone promotes the growth of these tumors. 

Risk factors may include a family history of fibroids, being obese, eating a diet high in red meat, and having high blood pressure. It also seems that black women are more likely to develop fibroids than other women, but it’s not clear why.²

What Happens to Fibroids After Menopause?

It’s not certain what causes uterine fibroids, but they typically form in child-bearing years when a woman’s body is making estrogen and progesterone. When you enter menopause, your ovaries stop producing estrogen and progesterone, and eventually your menstrual cycle stops.

The change in hormones decreases your likelihood of developing uterine fibroids. For those who do have fibroids, it often creates a decrease in fibroid-related symptoms. That’s because without hormones to “feed” them, the uterine fibroids may shrink and become less noticeable.³ 

Can Uterine Fibroids Develop After Menopause?

Getting uterine fibroids after menopause is extremely rare. It’s not clear why it happens when it does occur. Typically, uterine fibroids that occur after menopause should create much less severe symptoms than those being “fed” by estrogen and progesterone.³

However, the USA Fibroids Centers reports that one study found that while women may experience relief from their fibroid symptoms during menopause, postmenopausal women between the ages of 50 and 54 are affected by fibroids at higher rates. 

Other studies found that a decrease in fibroids during menopause may depend on race. Fibroids in black women and white women grow at similar rates up to the age of 35, when growth rates decline in white but not African American women. 

They conclude that more research is needed to understand the effects of fibroids during menopause.⁴

What Are The Symptoms of Uterine Fibroids After Menopause?

Women with fibroids may find the symptoms don’t change much after menopause. You will no longer have intense menstrual cycles every month—often made worse by fibroids—but you may still experience intermittent bleeding, cramps, a protruding belly, and frequent urination. 

Here are other possible symptoms of fibroids after menopause:

• You may not be able to fully empty your bladder.
• You may experience pain during intercourse.
• You may be more tired than usual.
• You may experience swelling and fullness in your belly.
• You may have lower back pain or leg pain.

Any of these could be signs of uterine fibroids, a reason to see a healthcare provider for diagnosis and possible treatment.⁴

Can Uterine Fibroids Cause Bleeding After Menopause?

There are instances when women with fibroids can experience bleeding even after menopause.

Here are some examples of cases when uterine fibroids may cause bleeding after menopause:

1. When women take hormone replacement therapy. The added hormones allow the fibroids to continue to grow. In some cases, hormone replacement can increase the risk for fibroid growth.⁴

2. When fibroids are calcified after menopause. This happens when a fibroid doesn’t get enough blood supply to maintain its growth, so the edges of the fibroid begin to calcify. In some cases, this causes the symptoms to worsen, increasing both bleeding and discharge.⁴

The Bleeding May Not Be Fibroids

Women with fibroids may experience heavy bleeding after menopausal age, but it may not be a sign of their uterine fibroids returning or getting worse—there could be something else going on. 

If you have bleeding after menopause, even if you have been diagnosed with uterine fibroids, you should not assume the bleeding is caused by your fibroids.

Since it’s very rare for fibroids to create such symptoms after menopause, your body could be sending you a signal that something else is wrong. It’s important to see a doctor for a proper diagnosis and treatment. Even if it is your fibroids, it’s better to know and have them treated if necessary.³

Do I Need Treatment for Fibroids After Menopause?

It’s best to talk to your doctor about possible treatment for your fibroids after menopause, in particular if the symptoms are causing issues. If you have bleeding after menopause, that’s a sign to promptly see a healthcare provider.

Luckily, there are non-invasive treatments for fibroids for both premenopausal and postmenopausal women. For instance, procedures such as Uterine Fibroid Embolization can shrink your fibroids without surgery. 

Radiologists use advanced technology to cut off blood supply to the fibroids, basically starving the fibroids and killing them off. This type of procedure also doesn’t interfere with hormones like when you have a hysterectomy or undergo hormone therapy.⁴

If your fibroids or your symptoms lessen after menopause, you may not need any treatment at all. You and your doctor can decide the best course of action for treating your fibroids after menopause. 

See A Doctor 

Uterine fibroids usually don’t cause bleeding after menopause, but there are instances where the symptoms remain even after your body stops producing estrogen and progesterone. If you have bleeding after menopause, you should see a doctor for a proper diagnosis.

In particular, see a doctor if you have pelvic pain that doesn’t go away, heavy or painful periods or spotting or bleeding between periods. Other warning signs include trouble emptying your bladder, and an ongoing tiredness or weakness which could be a sign of anemia. Seek medical attention immediately if you have severe bleeding from the vagina or sharp pelvic pain that comes on fast.¹ Use our Physician Finder to find a doctor near you with expertise in women’s health who can answer your questions about uterine fibroids. You can also seek guidance on other women’s pelvic health issues, like pelvic floor muscles exercises, and tools like Gynesis. Gynesis pelvic floor trainer shorts support women to take control of their pelvic health with a simple, effective, external, and accessible solution.  Using advanced technology, Gynesis delivers targeted muscle stimulation with Kegel exercises that helps retrain and rebuild your pelvic floor—so you can achieve stronger bladder control and with confidence.