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Postmenopausal Bleeding

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The natural cessation of the menstrual cycle in women is called menopause. It is considered the end of fertility. Menopause occurs when ovaries produce lower levels of estrogen and progesterone hormones. According to doctors, the condition of not having periods for one year continuously is considered menopause.

Usually, women do not have periods after menopause. If a woman has vaginal bleeding or spotting after menopause, it is called Postmenopausal Bleeding. It is best to visit your doctor, as it might be probably related to some underlying conditions.

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What are the Causes of Postmenopausal Bleeding?

The causes of Postmenopausal Bleeding are:

  • Uterine polyps: Any noncancerous cell growth in the uterus or the cervical canal is uterine polyps. It occurs in the inner wall of the uterus and can spread to the uterine cavity. Postmenopausal Bleeding can occur due to these tissue growths.
  • Thinning or thickening of the endometrium: Menopause is followed by hormonal changes, due to which the endometrial layer present in the uterine cavity becomes thin or thick at times; this can cause bleeding after menopause.
  • Thinning of vagina layer: After menopause, the vaginal wall may become thinner due to the depletion of estrogen hormones in the body, and makes the vagina dry and rough causing it to bleed during intercourse. With hormonal therapy, the vagina can get back to normal condition.
  • Cancer: Any cancer related to reproductive organs such as cervical or endometrial cancer can also cause bleeding.
  • Sexually transmitted disease (STD): Postmenopausal Bleeding can occur due to infections like chlamydia, gonorrhea, or herpes. These may require proper treatment and hygiene.
  • Side effects of medicines: Sometimes hormonal therapy medications may lead to blood thinning, and bleeding starts. Taking care while using these medicines is advisable.

What are the Symptoms of Postmenopausal Bleeding?

During postmenopausal bleeding, most women do not get any symptoms except bleeding. Some may feel these other symptoms too:

  • ● Insomnia
  • ● Gaining weight
  • ● Urinary tract infection
  • ● Stress
  • ● Vaginal dryness
  • ● Decreasing sexual desire

How is Postmenopausal Bleeding Diagnosed?

The doctor examines your medical history to find out the cause of bleeding. You may require the following tests:

  • Transvaginal ultrasound: The test helps the doctor to check abnormalities in the endometrium. The doctor places a small scan probe into the vagina. This probe transmits high-frequency sound waves into the body and creates a picture of the uterus and vagina.
  • Endometrial biopsy: The doctor uses a small thin tube that helps in collecting the tissue of the uterus wall. The tissue is sent to the lab for a microscopic test to examine the infection or cancerous cells.
  • Hysteroscopy: Hysteroscope (a small, thin, and flexible tube with a light and a camera on one end) is guided into the vagina. The doctor easily looks inside the uterus and finds the abnormalities causing Postmenopausal Bleeding.
  • Dilation and Curettage: In this process, the doctor opens the cervix and uses a thin tool to take the sample of the uterine lining. Later the sample is examined for cancer, polyps, etc., in the lab.

How is Postmenopausal BleedingTreated?

The treatment of Postmenopausal Bleeding depends on the causes of bleeding. The available treatments are:

  • Estrogen therapy: If the cause of bleeding is endometrial or vaginal atrophy, this treatment is an option. For the therapy, the doctor may prescribe:
  1. Vaginal cream
  2. Vaginal ring
  3. Pills
  4. Vaginal tablet
  • Progestin therapy: If the cause of Postmenopausal Bleeding is endometrial hyperplasia, progestin hormone therapy is helpful. You can take it as shots, pills, or vaginal cream.
  • Hysteroscopy: With this method, the doctor removes the polyps and also sometimes uses hysteroscopy to treat the thickness in the uterine lining. A hysteroscope is passed through the vagina, and some surgical tools are also set in the tube. The doctor administers local or general anesthesia to the patient during the procedure.
  • Dilation and Curettage: The surgeon dilates the cervix and removes the polyps with thickened areas of the uterine wall. This is one of the best surgeries to treat endometrial hyperplasia.
  • Hysterectomy: Endometrial or cervical cancer is treated with hysterectomy. In this procedure, some part or all of the uterus is removed. Depending on the risk of cancer, doctors may also remove the fallopian tube, the ovary, and the surrounding lymph nodes.

Hysterectomy is a good treatment option If a woman has endometrial hyperplasia, which can become cancerous.


Vaginal bleeding after menopause is Postmenopausal Bleeding, which is a severe condition. This bleeding due to polyps, thickening of the uterine lining, STD diseases, uterus cancer, etc. It is best you do not take it lightly. There are treatments available for every cause of postmenopausal bleeding. If cancer is the cause and has gone all over the uterus, the doctor performs a hysterectomy (removal of the uterus).

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Does Postmenopausal Bleeding Go Away on its Own?

Mild bleeding can occur in many women during menopause. It disappears in a day or two. If Postmenopausal Bleeding remains persistent, see a doctor immediately.

Are Periods Normal During Perimenopause?

Perimenopause is a condition right before menopause. During Perimenopause, you start getting periods late or in 2 to 3 months. During Perimenopause, if you bleed too much or every time after intercourse, visit your doctor for a checkup.

During Postmenopausal Bleeding, is it Safe to have Sex?

No, it is not advisable to have sexual activity during Postmenopause bleeding. It may cause pain and can promote the risk of infection in your partner.

Can Postmenopausal Bleeding be Treated with Birth Control Pills?

Treatment of Postmenopausal Bleeding depends on its cause, so consult your doctor before taking any contraceptive pills or other medications.

Can Thyroid Medication Treat Postmenopausal Bleeding?

Sometimes due to an imbalance in the thyroid, bleeding occurs even after menopause. In this case, thyroid medication may work.


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