Postmenopausal bleeding is something that occurs quite regularly and must be taken seriously. To understand what it means and why it may happen we need to know more about menopause.
What is Menopause?
Menopause is the time after a woman has her last period. Most women naturally become menopausal between the ages of 45 and 55 years. The average age of onset is around 50.
Final periods can be very irregular, so menopause is confirmed 12 months after that last period. Bleeding or spotting after this point is called postmenopausal bleeding (PMB).
You can read more about menopause here.
The menopausal transition.
Before menopause, there is a transition period which is called peri-menopause. Women may experience changes in menstrual periods such as regularity or changes in flow.
Changes are caused by fluctuations in the production of hormones from the ovary and symptoms can include hot flushes and night sweats, aches and pains, fatigue and/or irritability
Menopausal symptoms can be experienced for 5-10 years before menopause occurs.
What causes bleeding after menopause?
There are several different reasons why you may bleed post menopause. Including:
- thinning of the lining of your uterus
- thickened endometrium which can be due to hormone replacement therapy
- inflammation and thinning of the lining of your vagina
- Polyps in the cervix or uterus
- abnormalities in the cervix or uterus
These are not serious problems and are easily treated.
More serious reasons for bleeding.
Postmenopausal bleeding is also linked to cancer of the uterus or cervix.
Less than 10% of women who experience postmenopausal bleeding are found to have cancer. Family and personal history and use of hormone therapy do also affect these percentages.
Recent results have shown that 90% of women that have been diagnosed with endometrial cancer have experienced postmenopausal bleeding at an early stage of the disease.
This is the very reason to see a doctor at the first signs that something is not right. And bleeding post menopause must be investigated.
If you have any concerns, your first step is to visit your GP who will most likely refer you to a gynaecologist for further investigations.
Often postmenopausal bleeding is investigated with a hysteroscopy