Post Menopausal Bleeding

Postmenopausal bleeding is a condition in which  vaginal bleeding  occurs at least 12 months after woman periods have stopped. Once a woman is at her menopausal age (45-49 years normally) has lasted 12 months without a period, she is believed to be in menopause stage.

It is not normal to bleed after post menopause. Women with postmenopausal bleeding should always see a doctor, in order to rule out serious medical problems even if there is spotting.


Several health conditions are associated with postmenopausal bleeding, these conditions include:

  • Inflammation and thinning of the vaginal lining or thinning of the womb lining (endometrial atrophy) caused by lower estrogen levels
  • Polyps: Cervical or womb polyps, which are usually non-cancerous, can form in the cervix (neck of the womb) or womb 
  • Hormonal replacement therapy: A thickened womb lining (endometrial hyperplasia) caused by hormone replacement therapy 
  • Abnormalities of the cervix or the womb
  • Endometrial thickening: In this condition, the lining of the uterus (endometrium) becomes thick, usually as a result of too much estrogen and too little progesterone, and bleeding may occur as a result.
  • Endometrial cancer (uterine cancer): Bleeding after menopause can be a sign of endometrial cancer.
  • Other causes includes: Infection of the uterus or cervix, Certain medications such as blood thinners, and other types of cancer can cause postmenopausal bleeding.


For diagnosing the exact cause. Doctor may ask for the medical history  and may conduct a pap smear test. 

Further test that may be advised are:

  • A vaginal ultrasound
  • An endometrial biopsy (sample of the womb lining)
  • Hysteroscopy


Treatment depends on the cause of the post menopausal bleeding:

  • If bleeding is due to polyps, surgery may be required to remove them. 
  • Endometrial atrophy can be treated with medication such as oestrogen cream or pessaries , If post menopausal bleeding is due to   endometrial hyperplasia, it  might be treated with hormone treatment (progestin) or total hysterectomy (surgery to remove cervix, uterus and ovaries)  .
  • If post menausal bleeding is due to hormonal replacement therapy, HRT may be decreased/stopped depending upon the condition.


  • LAST UPDATED ON : Feb 04, 2016


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