Let’s add something else to the list of what’s certain in life for women: death, taxes … and your period. No one really likes ‘Aunt Flo,’ which is why menopause can be a welcome relief for many women. That’s because after you go through menopause, all bleeding stops, right? Wrong – at least for some women.
Postmenopausal bleeding is vaginal bleeding that happens after a woman has gone through menopause. It can be light or heavy, and you may experience pain or discomfort. While the reasons for it are often benign, postmenopausal bleeding is not normal, so it should always be checked by your doctor.
Here’s what you need to know about postmenopausal bleeding.
Menopause & Postmenopause
Menopause signals a milestone in our lives, typically occurring in your early 50s. You are officially in menopause when you have missed 12 straight months of your monthly cycle, assuming those missed periods are unrelated to other issues like illness, pregnancy, or breastfeeding. Postmenopause occurs after 1 year has passed since your last menstrual cycle.
Menopausal and postmenopausal women will experience a wide variety of symptoms (learn more about these symptoms and how to manage them here). And up to 10% of women over 55 will experience postmenopausal bleeding, which they should take seriously. 1
First, it’s important to note that postmenopausal bleeding is not a period (learn more about abnormal menstruation here). Instead, the blood may be coming from the uterus, vagina, or cervix, or anywhere else in the reproductive tract.
Postmenopausal bleeding can be as heavy as a regular period, or it may just be light spotting. You may notice the blood is pinkish or brownish. And while most of the time there is no pain,2 it is possible to experience pelvic pain or cramping (see 5 myths about pelvic pain here).
Most causes of postmenopausal bleeding are nonserious. For example, it can be a symptom of atrophy, in which blood vessels and lining in the vagina and uterus become thin and prone to breaking, 3 which can often be treated with simple topical estrogen cream. 4
Other typical causes of postmenopausal bleeding include endometrial hyperplasia, and uterine polyps and fibroids.
The biggest cause for concern for postmenopausal bleeding is that it could be a symptom of endometrial cancer, the most common gynecologic cancer in developed countries, which accounts for 5% of global cancer deaths in women. 5
That said, just because you are bleeding, don’t let your mind jump to the worst case scenario. Only 9% of women with postmenopausal bleeding will be diagnosed with this cancer, and early detection is key. 6
That’s why we’re spreading the word that women who are experiencing postmenopausal bleeding should speak to their doctors right away. If you have a serious condition, you want it treated promptly. And while the far greater likelihood is that you have a nonserious condition, ‘nonserious’ doesn’t mean it can’t impact your quality of life. And there’s no reason to suffer in silence like so many women do.
Diagnosing the cause of your postmenopausal bleeding usually begins with your doctor viewing inside the vagina and uterus and potentially taking a tissue sample. Other tests like a pelvic exam or transvaginal ultrasound may be used.
These tests are nothing to be afraid of, and you’ll feel so much better once you get some answers. Speak to your doctor, and if you need to find a pelvic health specialist in your area, please use our Physicain Finder.