Postmenopausal bleeding is any vaginal bleeding a woman experiences after menopause. Women attain menopause when 12 months pass after their last menstrual cycle. Normally, once a woman hits menopause, she should never have spotting or bleeding again. If that happens, it is not considered normal.
Many people associate bleeding after menopause with cancer. But is bleeding after menopause always cancer? Let’s find out.
So, Is Bleeding After Menopause Always Cancer?
Let go of your worries because bleeding after menopause is not always cancer! However, that does not mean you can neglect the occurrence, as it can be related to other health issues.
The reason why postmenopausal bleeding and cancer are often discussed together is because studies suggest that in 90% of the cases of endometrial (uterine) cancer, menopausal women reported vaginal bleeding before diagnosis. Plus, around 9–10% of women who visited a doctor for vaginal bleeding after menopause were found to have endometrial cancer after diagnosis. Sometimes, bleeding also indicates the possibility of cervical cancer.
What Else Can Cause Vaginal Bleeding After Menopause?
A number of noncancerous or benign conditions can trigger bleeding after menopause. Some of the common causes of bleeding in postmenopausal women are:
Uterine Fibroids
These are tumour-like growths inside or on your uterus. However, they are not cancerous. Fibroids are made of smooth muscles and tissues that either grow as clusters or form a single tumour. These can grow even after menopause, especially in women on hormone therapy, and cause symptoms like postmenopausal bleeding.
Uterine Polyps
Also called endometrial polyps, these structures are formed due to the overgrowth of cells found in the inner lining of the uterus. These too are benign; however, in some cases, they may turn into cancer. Polyps can vary in size and are more common in women who are in the later stages of perimenopause or those who have reached menopause.
Endometrial Atrophy
In this condition, the endometrium, which is the lining of the uterus, loses its thickness and endometrial glands, turning thinner than before. A decrease in hormones like oestrogen and progesterone can cause endometrial atrophy. As a woman’s body naturally stops producing more of these hormones after menopause, their risk of endometrial atrophy increases, and so do the chances of postmenopausal bleeding.
Endometrial Hyperplasia
This is a condition wherein the lining of the uterus thickens abnormally and can cause vaginal bleeding after menopause. The condition is known to increase the risk of endometrial cancer. Therefore, early detection can allow treatment of the condition.
Treatment of endometrial hyperplasia often involves progestin which can be administered in the form of pills, ingestions, vaginal creams, or intrauterine devices containing progesterone. Hysterectomy, or the removal of the uterus, is employed in serious cases.
Vaginal Atrophy
Another common cause of vaginal bleeding in postmenopausal women is vaginal atrophy. It is characterised by thinning and inflammation of the vaginal tissue. The condition is caused by low oestrogen levels in the body, which is typical in women who have stopped getting their periods. As the walls inside the vagina turn thin and dry, bleeding after sex becomes a common occurrence.
Hormone Replacement Therapy
Women taking hormone therapy for menopausal symptoms can experience either light bleeding or heavy bleeding, which may look like they’re having a period after menopause. If you bleed after menopause and are undergoing hormone replacement therapy, see your doctor to confirm if your bleeding is related to it or if there is any other underlying condition behind it.
Vaginal Injury
Injury caused by sexual abuse or other reasons can also lead to postmenopausal bleeding. Be mindful to avoid injury to your vagina or report the abuse to concerned authorities to avoid instances of vaginal bleeding in the future.
Inflammation of the Cervix
Cervicitis, also known as inflammation of the cervix, is a condition wherein the cervix gets inflamed due to a possible bacterial infection or irritation. The inflamed tissue is then more likely to bleed and can result in bleeding after menopause. Other noticeable symptoms are pus-like discharge, painful urination, and painful sex.
What To Do If You Experience Postmenopausal Bleeding?
First of all, relax! As we have already stated, there can be other reasons for the bleeding besides cancer. However, since any bleeding after menopause is not normal, you must seek medical attention without delay. Your doctor can examine you and come to a diagnosis. Along with taking your medical history, your doctor may conduct other tests:
Pelvic Exam: This is done to check the cervix and vagina for any abnormality.
Ultrasound: A transvaginal ultrasound is done to check the pelvic organs and the thickness of the uterine lining (thickening in the lining could suggest endometrial cancer).
Pap Smear Test: This test is used for cervical cancer screening. Cells from the cervix are collected and sent for testing.
Endometrial Biopsy: A sample of the uterine lining is removed and sent for testing.
What Treatment Options Are Available?
Treatment of postmenopausal bleeding depends on what’s causing it and usually involves medications or surgery. Your doctor will prescribe antibiotics for infection-related bleeding or order oestrogen supplements for addressing vaginal atrophy. Progestin pills or other forms may be advised if your bleeding is due to endometrial hyperplasia.
For cases where surgery is necessary, one can expect to undergo procedures like:
Dilation and Curette: This procedure is performed under anaesthesia and involves the removal of the uterine lining and its content. It can be employed for certain cases of endometrial hyperplasia.
Hysterectomy: This surgery is performed in cases of uterine cancer where the removal of the uterus and cervix becomes necessary.
While these are just options, it is important to discuss with your doctor to come up with the right treatment plan for your health. Feel free to clarify your doubts and build trust before accepting any treatment for your symptoms.
Takeaway
Cancer is not the only cause of postmenopausal bleeding. Other causes like thinning of the vaginal walls, uterine fibroids, and hormone therapy can also trigger bleeding after you have hit menopause. But since any kind of bleeding after menopause is not normal, you must get yourself examined by a doctor. Early detection of any health condition, including cancer, can speed up the treatment process and save you from complications.
We hope this post on “Is bleeding after menopause always cancer?” has clarified your doubts and put your concerns to rest. Take care!
FAQs
Should I worry about bleeding after menopause?
Bleeding after menopause is never normal. See your doctor for an examination. In most cases, the cause is not serious and easily treatable. But sometimes it could be serious and must be checked as soon as possible.
Can periods restart after menopause?
Periods do not restart after you have reached menopause and gone 12 months or more without periods. Any bleeding in women after menopause requires medical attention.
Who is at risk of postmenopausal bleeding?
People who smoke or have health issues like obesity, diabetes, thyroid conditions, and PCOS can have higher chances of bleeding after menopause.
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