Post-menopause begins when a woman has missed 12 consecutive menstrual cycles. At this stage, vaginal bleeding is highly abnormal and usually indicates a medical condition or disease. Although some of these conditions are benign, it is best to have all instances of bleeding post-menopause investigated by a health professional.
End of Menstruation
Nearing the end of a woman's reproductive years, the hormone estrogen declines with each menstrual cycle. Once the level has declined significantly, menstruation ends, so all instances of vaginal bleeding post-menopause are abnormal.
Uterine Causes
Women who are in post-menopause may have an overgrowth of cells in the uterine lining. This overgrowth is called endometrial hyperplasia. During menopause, when declining hormone levels cause symptoms such as hot flashes, mood swings, insomnia and vaginal dryness, some women take hormone replacements to relieve the symptoms. Taking estrogen supplements without adequate progesterone can cause endometrial overgrowth and possibly bleeding. Polyps, usually benign, may also develop in the lining and bleed.
Vaginal Causes
When estrogen declines in menopause, the vaginal walls thin and become inflamed. This condition is called vaginal atrophy and is mostly problematic in post-menopause. Women who have vaginal atrophy may also experience vaginal dryness, vaginal burning, burning in urination, urinary frequency, pain during intercourse, light bleeding after intercourse and the shortening of the vaginal canal. Treatment consists of estrogen therapy and the use of lubricants during intercourse. MayoClinic.com states that regular sexual activity enhances blood flow to the vagina, which can help to prevent this condition.
Serious Causes
Bleeding during post-menopause can be a sign of endometrial cancer. MedlinePlus states that endometrial cancer occurs more in women in their 60s and 70s. The risk increases in women with diabetes, a history of uterine polyps or growths and who use estrogen replacement therapy without progesterone. It also increases in women who are obese, infertile, who have never had children, have had polycystic ovary syndrome, started menstruating before age 12 or entered menopause after age 50. Symptoms of endometrial cancer are uterine bleeding, bleeding after menopause, pelvic pain and vaginal discharge after menopause.
Warning
All instances of bleeding post-menopause are abnormal. Consult your doctor, and seek emergency care if bleeding is sudden, heavy or accompanied by pain.
