After menstruation ends, women should not experience any sort of bleeding or spotting. However, as abnormal as the bleeding may be after menopause, some women still experience it. Although it is no longer menstrual bleeding, there are other causes for bleeding after menopause.
Menopause
There are three stages of menopause: perimenopause, menopause and postmenopause. Perimenopause is the transitional stage that occurs before menopause begins, when estrogen begins to decrease. In this stage a woman will still have a menstrual cycle, although it will be irregular due to the irregular levels of estrogen and progesterone. Menopause is the stage that marks the end of a woman's reproductive years. Menopause occurs when a woman has missed her menstrual cycle for 12 consecutive months. In this stage, the ovaries don't produce enough estrogen to maintain menstruation or ovulation. This stage normally occurs in a woman's 40s or 50s. Menopause can occur sooner if a woman has undergone a surgical procedure such as a total hysterectomy, which removes the ovaries and uterus. Postmenopause occurs in the years following menopause.
Why is Bleeding in Menopause Abnormal?
A woman who is in menopause no longer menstruates, so any bleeding experienced in this stage is abnormal. During a woman's reproductive years, estrogen and progesterone cause the uterine lining to shed, along with some of the plush uterine tissue, which causes menstrual bleeding; this cannot occur in menopause due to the severe decline in estrogen. Some causes of menopausal bleeding may be benign, but it is abnormal, nonetheless.
Causes of Abnormal Bleeding
One cause of bleeding in menopause is endometrial hyperplasia. Endometrial hyperplasia is a condition that is caused by the uterine lining over growing. This condition to begin with is benign, but if left untreated can become cancerous. According to the Endometrial Hyperplasia website, women who are taking estrogen supplements in menopause without progesterone may cause the uterine lining to become dangerously hyperplastic, or over-grown. Women who have this condition may experience bleeding or spotting. Another cause of bleeding in menopause is vaginal atrophy. Vaginal atrophy in menopause results from the vaginal walls thinning in response to a lower level of estrogen. The thinning of the walls makes the vaginal tissues more fragile and drier. MayoClinic states that women with this condition have vaginal dryness, burning, burning with urination, urinary frequency, bleeding after intercourse and discomfort during intercourse.
Treatments
Mild vaginal atrophy can be treated at home with the use of personal lubricants. These lubricants can be purchased over-the-counter at most drug stores. One alternative is to use topical estrogen, which must be prescribed by a doctor. These estrogen replacements can come in the form of cream inserts, vaginal rings or tablets. Endometrial hyperplasia can be treated with the use progesterone supplements. This supplements must be prescribed by a physician and taken as directed. In severe cases of hyperplasia, a hysterectomy may be necessary to completely remove the uterus.
Warnings
Any bleeding in menopause should be reported to a health professional. Even spotting without pain can indicate a serious condition.
