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Postmenopausal Bleeding: Know The Facts, Causes, Symptoms and How To Help


February 21, 2021

Postmenopausal Bleeding Know The Facts Causes Symptoms and How To Help

Postmenopausal Bleeding – The Facts

If you have experienced spotting after menopause, you are not alone. It is very common to have bleeding after menopause at a younger age but you may question why an older woman would bleed after menopause. If you want answers, read on.

Understanding Menopause

As women age, they go through tremendous changes in their bodies. When women are younger, most of their bodily functions relate to childbearing activities. However, after they reach their late 40s, their body begins to move away from childbearing and the processes of procreation. This results in a natural decline of reproductive hormones in their bodies. This phase in their lives is called menopause.

Menopause is defined as the continuous period of 12 absent bleedings since the last menstrual cycle. In simple words, when an older woman does not have periods for a year, she has hit menopause.

For women in the United States, the average age of menopause is 51 years. The process begins with perimenopause (start of the process), menopause, and post-menopause (around 36 months after the last periods).

Causes for Postmenopausal Bleeding

Brown spotting after menopause may be caused by a variety of reasons. You might have questions such as ‘what are the dangers of brown spotting after menopause?’ or ‘can stress cause postmenopausal bleeding?’ But what most women are curious about is what is the most common cause of postmenopausal bleeding. We will try to answer them here.

First of all, if you experience postmenopausal bleeding, the first thing you should do is see a doctor. They will help you understand what might be causing this vaginal spotting after menopause. However, these are the most common reasons for cramping and spotting after menopause.

1. Endometrial Polyps

The primary cause for bleeding after menopause appears to be polyps. These polyps develop in the cervix or sometimes become attached to the wall of the uterus. These can be cancerous or non-cancerous. They also vary in size from a few millimeters to centimeters. These can be removed through surgery after being diagnosed.

2. Endometrial Hyperplasia

This condition is a result of a hormonal imbalance in the woman’s body, especially the hormones estrogen and progesterone. The imbalance in turn can cause spotting after menopause.

3. Cancer

A more serious cause of bleeding after menopause may be some form of cancer in the cervix or uterine lining. Both these types of cancers result in abnormal tissue growth and both cause abnormal bleeding from the vagina. A major cause of this is HPV (human papillomavirus).

4. Atrophic Vaginitis

Another cause of bleeding after menopause is the thinning of the uterine lining. This thinning is usually a result of a drop in hormones such as estrogen. In this condition, the vaginal mucosa becomes drier, thinner, and inflamed. This can then cause vaginal spotting after menopause.

5. Stress

You may have been told many times that stress is bad for women’s reproductive health, and it is true. Both physical and mental stress can cause serious effects on your body. The stress in your body translates into the abnormal production of many reproductive hormones. This then can cause cramping and spotting after menopause, depression, anxiety, mood swings, and even insomnia.

Here we would like to stress again that whatever the case may be, it is never a good idea to diagnose the problem yourself. Always consult a gynecologist if you are experiencing any postmenopausal bleeding.

What are Postmenopausal Bleeding Symptoms?

Women may experience different symptoms with this condition. Some might have a few of these signs and symptoms, while others may only have bleeding, and a few might experience all of the symptoms. Here are some of the postmenopausal bleeding symptoms for which you should look:

  • Weight gain
  • Increased incidence of UTIs
  • Stress incontinence
  • Insomnia
  • Decreased sex drive
  • Vaginal dryness
  • Brown spotting

How Can It Be Diagnosed?

There is nothing to fear when you undergo an examination at your doctor’s office. If you have experienced postmenopausal bleeding, your doctor will likely perform a physical examination and will also take a detailed medical history. It is likely that a doctor will also order a pap smear that is used to screen for cervical cancer in women.

You are also likely to undergo other detailed procedures that will look into your vagina and uterus. These might be:

Transvaginal Ultrasound

This will help the doctor better see your ovaries, cervix, and uterus. During the examination, a technician will put a probe inside your vagina and look at an image on the screen. They will likely use a lubricant and the process is slightly uncomfortable but not painful.


This exam looks at the endometrial tissue of your reproductive tract. At first, the doctor or a technician will insert a fiber-optic into your vagina and then pump carbon dioxide through the scope. This then helps expand the uterus and makes it easier to see inside and diagnose the problem.

How Postmenopausal Bleeding is Treated?

Treatment of postmenopausal bleeding can be based on multiple strategies. The treatment plan is dependent upon things such as whether the bleeding is heavy or light or what might be the root cause of the problem. Kindly read more here the 5 remedies on how to stop heavy periods.

The treatment can include things such as:

  • Estrogen like Natural Estrogen Cream and progesterone creams may be prescribed if you are bleeding due to thinning or atrophy of your vaginal tissue. Read more here about Vaginal Atrophy: Natural Remedies to Ward It Off.
  • Polyp removal may also be performed by your doctor, which is a surgical process.
  • You might also be given progestin which is basically a hormone replacement therapy. If your endometrial tissue is grown, you might be prescribed this particular therapy.
  • A hysterectomy might also be suggested by your doctor. During this procedure, the uterus of the woman is removed either laparoscopically or through conventional abdominal surgery.
  • You might have to undergo chemotherapy, surgery, and radiation therapy if the root cause of the problem is endometrial or cervical cancer.

The Postmenopausal Prognosis

You do not have to worry, as in most cases, postmenopausal bleeding can be treated successfully. However, if the bleeding is occurring due to cancer, there is still an 82 percent chance that you will recover fully. So, first and foremost, visit your gynecologist if you experience any such issue. Self-prognosis is always discouraged and the patients are urged to visit qualified doctors.

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