Post Menopause Bleeding

Overview of Post Menopause Bleeding

Post Menopause Bleeding Meaning in Urdu

مینوپاز ایسی حالت کو کہتے ہیں جب خواتین کو ایک سال تک ماہواری نہیں آتی۔ عام طور پر پنتالیس سے پچاس سال کی عمر کی خواتین کو حیض آنا بند ہو جاتا ہے۔ تاہم کچھ خواتین کو مینوپاز کے بعد بھی اعضائے مخصوصہ سے خون آ سکتا ہے۔ جب خواتین میں ایسٹروجن کا لیول کم ہو جائے تو  ویجائنا کا پردہ سوزش کا شکار ہو جاتا ہے جس سے مینوپاز کے بعد بھی خون بہہ سکتا ہے۔ اس کے علاوہ کچھ خواتین میں موٹاپے کی وجہ سے بھی مینوپاز کے بعد خون آنے کے خطرات موجود ہوتے ہیں۔


Postmenopausal or post-menopause bleeding is bleeding that occurs in the female after menopause. Menopause is a stage or condition in the life of a female (above 45 and around 51) when the hormones for reproduction drop and her monthly periods are stopped. If a woman suffers from abnormal vaginal bleeding that occurs a lot after the first year a woman had her last period is not normal. The bleeding can be light (spotting) or heavy. 

Post-menopausal bleeding is normally due to benign (noncancerous) gynaecological conditions such as endometrial polyps. But, in about 10% of the women who suffer from bleeding after menopause, it is a sign of uterine cancer. It is one of the most common types of reproductive cancer in females as compared to cervical or ovarian cancer.



Postmenopausal bleeding occurs in approximately 10% of women who are over 55 years of age.



Signs and Symptoms of Post Menopause Bleeding

The post-menopause bleeding symptoms can range from light spotting i.e. pinkish grey or heavy flow-like period i.e. brown. Normally there is no pain in this bleeding. But, no matter what the symptoms are, you need to visit a certified Obs/Gynae as soon as possible.


Types of Post Menopause Bleeding

Causes of Post Menopause Bleeding

The post-menopause bleeding causes vary from patient to patient. In fact, there is a number of reasons that can cause postmenopausal bleeding such as

  • Polyps - The polyps are the tissue growth that appears inside of your cervical canal, uterus, or on your cervix. They are not due to cancer, but they can definitely cause excessive bleeding or bleeding after sex.
  • Thinning of Uterine Bleeding (Endometrial Atrophy) - The uterus is lined with the tissues known as the endometrium. It responds to the progesterone and oestrogen. This lining can get thin after menopause due to low hormones. This can further lead to bleeding.
  • Thickening of Uterine Lining (Endometrial Hyperplasia) - After menopause, you may have too little progesterone and too much oestrogen. Due to this, the endometrium gets thick and bleeding starts. At times the cells present in the endometrium become abnormal and it can lead to cancer. Therefore, this condition needs to get treated as soon as possible. 
  • Thinning of Vaginal Tissue (Vaginal Atrophy) - The tissues of the vagina are kept healthy due to estrogen. The levels of estrogen lower after menopause and this makes the wall of the vagina become thin, inflamed and dry. This can cause bleeding after intercourse (sex).
  • Sexually Transmitted Diseases (STDs) - The STDs such as gonorrhoea and chlamydia can also cause bleeding after intercourse. The sores due to herpes can also bleed due to this.
  • Medication - The post-menopause can also be due to certain medicines such as hormone therapy, blood thinners, and tamoxifen.
  • Cancer - Bleeding is one of the most common symptoms of uterine cancer or endometrial cancer and cervical or vaginal cancer.
  • Endometritis or cervicitis (i.e. inflammation or infection in the uterus or cervix)
  • Bleeding from other areas such as the rectum or bladder or bleeding from the skin of the vulva.



Risk Factors of Post Menopause Bleeding

Who is more likely to suffer from Postmenopausal Bleeding?

Anyone can suffer from vaginal bleeding, especially during perimenopause. It is a time that leads to menopause. It usually starts between the age of 40-50 years of age. It is basically the phase in the life of a woman’s hormone levels when the period starts to change.




In most cases, post-menopause bleeding is not prevented. But, in case of endometrial hyperplasia i.e. heavy bleeding, even if it is not prevented but you can lower the risk by reducing weight in case you suffer from obesity.




The postmenopausal bleeding diagnosis is done by a certified Obs/Gynae. The doctor will first do your physical exam and check your medical history. The doctor would recommend some of the following tests for post-menopausal bleeding diagnosis.

  • Transvaginal Ultrasound - The TVS ultrasound will help the doctor to check the thickness of the endometrium and to look at growth as well. 
  • Endometrial Biopsy - The doctor takes a tissue sample of the uterus with the help of a thin tube in the biopsy. It is then further tested for any infection or cancerous cells.
  • Hysteroscopy - A hysteroscopy is used by the doctor to examine the inside of the uterus. It is a thin lighted tube that has a camera on one end.
  • Sonohysterography - This test is used to measure the size of the polyp. The saltwater solution is poured inside the uterus to get a clear image of ultrasound.
  • D & C (Dilation and Curettage) - In this procedure, the doctor dilates the cervix. A thin tool to suck or scrape the sample from the uterus lining. It is then sent to a lab to check for cancer, polyps, or thickening of the uterine lining.

Biopsy and ultrasound are normally done in the doctor’s office. While D & C and hysteroscopy require anaesthesia on either one part of the body or the whole so for this, you need to visit a hospital or surgical centre OPD.


Treatment of Post Menopause Bleeding | When to Consult a Doctor

Postmenopausal bleeding treatment depends on the cause of the bleeding. Based on this the treatment options are:

  1. Estrogen Therapy

The estrogen hormone is used to treat endometrial and vaginal atrophy. It can be recommended by your doctor in the following forms:

  • Pills - These are the oral medicines that you’ll have to take.
  • Vaginal Cream - You can use it with the help of an applicator.
  • Vaginal Tablet - You’ll require an applicator for it. You may require it daily or a few times a week as prescribed by your doctor. 
  • Vaginal Ring - Your doctor or even you can put it by yourself in the vagina. It releases a steady amount of estrogen in your vagina for about 3 months.
  1. Progesterone Therapy 

 It is used to treat endometrial hyperplasia. Your doctor can prescribe it in the form of a shot, pill, vaginal cream, or IUD (Intrauterine device).

  1. Hysteroscopy

This specialised procedure is used to remove the polyp. Doctors particularly use this procedure to remove the part of the uterine lining that is thickened due to endometrial hyperplasia. 

  1. Hysterectomy 

It is a specialized surgical procedure in which the whole uterus is removed. It is a specialized treatment for cervical or endometrial cancer. People who suffer from a precancerous form of endometrial hyperplasia may also need it. In other cases, the doctor may also remove your ovaries, lymph nodes, or fallopian tubes.

  1. D&C (Dilation and Curettage) 

Doctors use this surgical procedure to open your cervix. In this, they use a thin tool to remove the polyps or thickened areas of the uterine lining due to endometrial hyperplasia.

  1. Hormone Therapy, Chemotherapy, and Medication

After the surgery, you may also require more cancer treatment. Based on the type and stage of cancer, your doctor will prescribe the treatment accordingly.

  1. Medication

Doctors can also prescribe medication such as antibiotics for STDs. They are also able to treat cervical and uterine infections. 

(Note: Take the medicine only after the doctor’s prescription. Self-medication is injurious to health)In case of any ambiguities and concerns regarding post-menopause bleeding, you can easily reach out to certified gynecologists via Healthwire.