Bleeding after menopause

POSTMENOPAUSAL BLEEDING

Menopause is the very last period. Because the final periods can be irregular, menopause is confirmed 12 months after the last period. Any bleeding or spotting after this is postmenopausal bleeding. It is not normal to bleed or spot 12 months or more after the last period.

Postmenopausal bleeding needs to be checked out by a doctor. Mostly, the cause will be something very simple and treatable, but occasionally it is a sign of more serious disease.

CAUSES OF POSTMENOPAUSAL BLEEDING MAY INCLUDE

  • Thickening of the endometrium, called endometrial hyperplasia

  • Growths in the cervix or uterus (called polyps) which are usually not cancerous

  • Thinning of the lining of the endometrium

  • Sometimes postmenopausal bleeding can be due to cancer of the endometrium or cervix.

INVETIGATING THE CAUSE OF POSTMENOPAUSAL BLEEDING

Any postmenopausal bleeding should be investigated urgently by a pelvic ultrasound examination and/or an endometrial biopsy to exclude endometrial cancer or pre cancer.

TREATMENT OF POSTMENOPAUSAL BLEEDING DEPENDS ON THE CAUSE

Thickening of the endometrium is treated with the hormone progesterone and/or surgery to remove the thickening.

Endometrial polyps are surgically removed using a hysteroscope and endometrial cancer is treated by total hysterectomy and bilateral salpingo-oophorectomy.