Postmenopausal bleeding can be alarming. Menopause means the end of menstruation, so bleeding after menopause is not normal. There are many possible causes for postmenopausal bleeding. Some causes are harmless, while others may be serious. Vaginal or endometrial atrophy, hormone therapy, infection of the cervix, uterine fibroids and polyps, and cervical and endometrial cancer are potential causes. Postmenopausal bleeding should be evaluated by a physician.
Hormone Therapy
Hormone therapy supplements estrogen and progesterone, the hormones that decline during menopause. Women who have had a hysterectomy receive estrogen only, explains the National Institutes of Health website, Medline Plus. Hormone therapy is used to relieve distressing symptoms of menopause including mood swings, night sweats, hot flashes, vaginal dryness and sleep disorders. When hormone therapy is taken daily, irregular bleeding can occur for up to one year. Cyclic hormone therapy can cause monthly bleeding. According to the American Academy of Family Physicians, bleeding that persists six to nine months after starting hormone therapy requires further evaluation.
Endometrial Cancer
Endometrial cancer usually develops after menopause between the ages of 50 and 60. It starts in the lining of the uterus, called the endometrium, explains Memorial Sloan Kettering Cancer Center. Postmenopausal bleeding occurs in 90 percent of women with endometrial cancer, and because of this, it is commonly diagnosed in its early stages when it is most treatable. Vaginal discharge that is watery, pink or white may occur instead of bleeding. Other symptoms include pain during intercourse or urination, and pelvic pain and unexplained weight loss in later stages. Other conditions of the uterus that can cause postmenopausal bleeding include endometrial hyperplasia, fibroids, polyps, cervical cancer and cervical infection.
Atrophic Vaginitis
Atrophic vaginitis, also called vaginal atrophy, is caused by decreased estrogen after menopause. It results in thinning and inflammation of vaginal tissue, according to MayoClinic.com. Symptoms include light bleeding after intercourse, painful intercourse, vaginal dryness and burning, watery vaginal discharge, shortening and tightening of the vagina and increased urinary tract infections. Treatment includes vaginal lubricants or moisturizers, estrogen applied to the vagina and hormone therapy.
