Menopause occurs after your final menstrual period. Since the last periods might be irregular, menopause is officially diagnosed after 12 months have passed without menstruation. Any spotting or bleeding that happens after this time is referred to as postmenopausal bleeding (PMB).
It's important to see a healthcare professional if you experience postmenopausal bleeding. While it is often due to minor, treatable problems, it can sometimes indicate a more serious condition.
Bleeding or spotting for 12 months or even more after your final menstrual period isn’t normal. Although postmenopausal bleeding is often associated with less serious health concerns, it can occasionally be an early warning of a more severe illness. Early detection of the conditions leading to bleeding after menopause, like cancer, significantly increases the chances of successful treatment.
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Postmenopausal bleeding is not usually something to worry about. Nonetheless, it should still be examined since it may be a sign of a severe problem.
In almost 90% of all cases, no specific reason for postmenopausal bleeding has been identified, which is generally not a cause for concern. However, if there is a serious issue, it will be detected during medical examination.
The possible causes of postmenopausal bleeding include:
Furthermore, certain drugs, such as tamoxifen, hormone therapy and blood thinners, can lead to postmenopausal bleeding.
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To determine the cause of bleeding after menopause, your doctor will perform a physical examination and assess your medical history. One or more of these diagnostic tests may also be recommended:
D&C (dilation and curettage): This procedure involves dilating the cervix and using a tiny instrument to scrape or suction a uterine lining sample. The sample is then taken to the lab to examine for cancer, polyps, or uterine lining thickening (endometrial hyperplasia).
Treatment is usually determined by the underlying cause of the postmenopausal bleeding. The options include:
Healthcare providers recommend this hormone to treat endometrial and vaginal atrophy. It may be prescribed in various forms, such as:
This is a synthetic progesterone version used to address endometrial hyperplasia. It can be administered in the form of pills, shots, vaginal creams, or via an intrauterine device (IUD).
Doctors can recommend this procedure to take out polyps or thickened areas of the uterine lining that occur due to endometrial hyperplasia. A hysteroscope is inserted inside the vagina, and thin surgical equipment is passed via the tube.
During this procedure, the doctor dilates or opens the cervix and uses a tiny instrument to take out polyps or thickened parts of the uterine lining due to endometrial hyperplasia.
This involves the removal of a section or the whole uterus. It is normally used to treat cervical or endometrial cancer. Hysterectomy may also be recommended for individuals with a precancerous type of endometrial hyperplasia. At times, fallopian tubes, the ovaries, or surrounding lymph nodes may also be removed.
These treatments may be necessary following surgery to treat cancer. The specific approach depends on the type and stage of the cancer.
The healthcare provider can suggest medications such as antibiotics to treat sexually transmitted diseases or eliminate infections of the cervix or uterus.
In general, women experiencing bleeding after menopause have good outcomes. For women with symptoms unrelated to cancer, drugs and other treatments can help halt the bleeding.
If the bleeding is due to endometrial cancer, prompt diagnosis and treatment significantly improve the prognosis. About 95% of all women with endometrial cancer survive for five years or even more when the condition is detected early. For cancer that has spread to the surrounding body areas, the five-year survival rate is reduced to 69%. On the other hand, there is only an 18% 5-year survival rate when the cancer reaches distant parts.
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