Unexpected bleeding can always be worrisome, but it is even more unsettling with it happens during the years after your ovaries and uterus are no longer producing ovum and you do not have any tampons or pads on hand. Bleeding after menopause isn’t just about making the emergency run for sanitary products, but it is the huge fear that blood may equal cancer, which makes women spend hours reading on the internet for reassurance. However, be relaxed, because even though many women imagine the worse, in most cases, bleeding after menopause isn’t any serious.
What Causes Bleeding After Menopause?
After a woman has gone twelve months with no period, she is thought to be in the stage of menopause. Any vaginal bleeding that happens after this twelve-month timeframe is thought to be bleeding after menopause. Women who experience postmenopausal bleeding should always visit their doctor so that the underlying causes can be discovered.
Polyps are usually non-cancerous growths of tissue lining the inside of the uterus, and can cause you to experience vaginal bleeding after menopause. The growths that are attached to the uterine wall and the endometrial surface can sometimes cause pretty heavy and irregular bleeding. The polyps can grow on the cervix as well or in the cervical canal, resulting in irritation and bleeding. Many women who are post-menopausal have stated their experience of bleeding after sex from polyps.
2. Endometrial Atrophy (Thinning of the Endometrium)
You can also experience vaginal bleeding after menopause if the uterine lining or endometrium thins out. A woman may experience uterine atrophy after menopause, a condition in which the uterine lining gets too thin and starts to die because of the lower levels of estrogen. The thinning of the lining, therefore, will cause vaginal bleeding.
3. Endometrial Hyperplasia (Thickeningof the Endometrium)
This is another common cause of postmenopausal bleeding, and is simply an abnormal thickening of the uterus. Besides bleeding after menopause, this can sometimes cause changes in the uterine lining, therefore, resulting in atypical hyperplasia, which is a dangerous condition and could even lead to uterus cancer.
4. Infection of the Uterus
A uterus infection could also be a reason for vaginal bleeding after menopause. It has been found that a postmenopausal woman could experience vaginal bleeding during a pelvic exam, a pap smear or after sex during an infection. Usually this occurs because of lower estrogen levels and the uterine lining being thinned out. You need to be careful during these times since any kind of sexual activity or vaginal exams could tear the thin uterine lining, causing vaginal bleeding.
5. Endometrial Cancer (Uterine Cancer)
This is a kind of cancer which starts in the uterus. Many times it is detected at an early stage since it frequently causes abnormal vaginal bleeding, prompting women to go to their doctor. You could also experience watery, abnormal, blood-tinged discharge or pelvic pain if you are suffering from endometrial cancer.
6. Other Causes
Use of certain kinds of medications like blood thinners, hormone therapy and other types of cancer besides uterine cancer can cause postmenopausal bleeding, too.
How Is Bleeding After Menopause Diagnosed?
It can be determined by your doctor what the cause of bleeding is by checking your medical history and making a physical exam and some tests, which include:
- Transvaginal ultrasound. An imaging device is inserted into the vagina during this test, enabling your docor to see the pelvic organs and look for anything which is unsual.
- Endometiral biopsy. A thin tube is inserted into your uterus, and then a tiny sample of the lining is taken out. It is then sent to a lab to check for anything unusual.
- A sonogram which is saline-infused. Going through the cervix, saline is put in the uterus with a thin, small tube. With ultrasound, your doctor look for any masses in the uterine lining. This is done many times along with an endometrial biopsy.
- Hysteroscopy. Your doctor will use an instrument with a light and small camera during this test to look at the inside of the utuers and search for any problems.
- D&C (dilation and curettage). This type of test enables your doctor remove tissue from the uterine lining, so it can be sent to a lab to be analyzed.
Biopsy can be performed in your doctor’ office, and D&C and hysteroscopy are generally done in an outpatient surgical center or a hospital.
How Is Bleeding After Menopause Treated?
Bleeding might not need any treatment for some cases. And if needed, the treatment will basically depend upon the cuase of the bleeding, whether it is heavy or any other symtpoms are present. Afterthe cause is ruled out, treatments usually include the following:
- Estrogen creams. Your doctor could prescribe estrogen cream if your bleeding is from the atrophy and thinning of your vaginal tissues.
- Polyp removal. This is a common surgical procedure to polyps. It is performed by typing it at the base tightly, and then twisting or removing it with forceps.
- Progestin. This is a hormone replacement. Your doctor could recommend it if your endometrial tissue is overgrown. Progestin can lower the overgrowth of tissue and lessen the bleeding.
- Hysterectomy. Bleeding which can’t be treated in a less invasive way could need a hysterectomy. During this procedure, your doctor will remove your uterus. This could be done laparoscopically or through conventional abdominal surgery.
If the bleeding is because of cancer, the treatment will depend upon the kind of cancer and how far advanced it is. Common treatment for cervical or endometrial cancer can include chemotherapy, surgery and radiation therapy.