Health
Postmenopausal Bleeding: What You Should Know
Health Points
- Postmenopausal bleeding is common but should always be checked by a healthcare professional.
- Most causes are not serious, with atrophy and polyps among the most frequent reasons.
- Hormone therapy or thicker uterine lining can also lead to bleeding, while cancer is less common.
Seeing blood after menopause can be worrisome, but you’re not alone—at least 10 percent of women experience it. Still, prompt evaluation ensures any underlying cause gets managed quickly.
Thinning tissue, called atrophy, is a leading factor behind spotting or bleeding because it makes the uterine or vaginal walls more fragile.
“This is the most common cause of postmenopausal bleeding,” says Dr. Mary Rosser, director of integrated women’s health at Columbia University’s Irving Medical Center.
If you notice bleeding, it’s worth discussing with your doctor, as hormonal or nonhormonal treatments often help.
Another possibility is fibroids—benign growths that sometimes appear after menopause, though less frequently due to lower estrogen levels.
Dr. Rosser shares, “When fibroids are present in postmenopausal women, they may manifest as abnormal uterine bleeding.”
However, most who have fibroids after menopause don’t need treatment unless the bleeding is persistent.
Endometrial hyperplasia—when the uterine lining grows too thick—can also cause warning signs. This condition can increase health risks if not addressed.
Women may be more at risk if they’ve never been pregnant, began periods early, have PCOS, obesity, or certain medical conditions.
Treatments vary from hormone therapy to minor procedures, depending on your situation.
Postmenopausal hormone therapy helps manage symptoms but breakthrough bleeding can occur, especially in the first half-year.
Speak to your healthcare provider if bleeding continues after the first six months of hormone therapy, or if it worsens.
Polyps are small, benign overgrowths inside the uterus that may trigger irregular bleeding; removal is often advised to rule out malignancy.
Postmenopausal uterine or endometrial cancer is rare, but it’s a possible cause—though only about 10 percent of those with bleeding receive this diagnosis.
“Most cases of postmenopausal bleeding are due to benign conditions such as polyps or tissue changes,” Dr. Rosser notes.
If you experience any bleeding after menopause, make an appointment for a thorough evaluation. Staying in touch with your healthcare team ensures peace of mind and the best care moving forward.
