Menopause is the cessation of menstruation as a result of the normal decline in ovarian function. A woman enters menopause after 12 consecutive months with no menstrual period. Until a woman is technically considered menopausal, she's considered to be in perimenopause, and it is during the perimenopause that many women experience a variety of physical and psychological symptoms, such as hot flashes, anxiety or depression. If a woman experiences vaginal bleeding after entering menopause -- or any other symptoms reminiscent of menstruation -- she should contact her gynecologist.
Bleeding
A woman experiencing vaginal bleeding after menopause should check immediately with her doctor, who may order tests to check hormone levels, and perform a pap smear and a pelvic examination to view her ovaries and uterus. Further testing may be required if abnormalities are suspected or if bleeding continues.
Postmenopausal vaginal bleeding may manifest as spotting or as a heavy flow. Factors that contribute to vaginal bleeding after menopause include nutritional deficiencies, emotional stress and drastic weight loss.
Benign growths in the uterine cavity may result in either irregular light bleeding if polyps are present, or heavy bleeding if fibroids are present. In women over 60, vaginal bleeding after menopause may be due to endometrial cancer or other serious condition, especially if accompanied by symptoms such as vaginal discharge, pelvic pain and pressure on the bowels or bladder.
MedlinePlus explains that women who use continuous combined hormone replacement therapy may have irregular menstrual cycles even after menstruation has stopped. Switching to a different type of hormone replacement therapy may also lead to irregular bleeding. If a woman bleeds again following the 6- to 12-month adjustment period after hormone therapy, this is also considered abnormal.
Occasionally, bleeding will signify that menstruation has started again and that a woman is not postmenopausal after all. This is even more likely when other symptoms, such as breast tenderness, accompany the bleeding.
Cramps
Pain similar to intense menstrual cramps and lower back pain may also be the result of endometriosis, a gynecological condition affecting 1 in 10 women, according to Harvard Women's Health Watch. Endometriosis is more common during a woman's reproductive years, but can also occur after menopause. Women with endometriosis have a higher-than-average risk of acquiring autoimmune disorders, chronic fatigue syndrome, hypothyroidism, fibromyalgia and ovarian cancer.
Breast Tenderness
MayoClinic.com explains that cyclical breast pain is related to the way breast tissue reacts to monthly changes in women's estrogen and progesterone hormone levels. Breast pain or tenderness is common before and during a menstrual period, and usually ceases when menstruation is over. Breast pain usually signals a benign breast condition, and seldom indicates breast cancer; however, if a woman experiences unexplained breast pain that doesn't go away or persists after menopause, she needs to be examined by her doctor.
References
- Power-Surge: An Introduction to Menopause and Perimenopause: Signs, Symptoms and Treatments
- Menopause To Health: Are You Bleeding After Menopause?
- TargetWoman: Vaginal Bleeding After Menopause
- MedlinePlus: Hormone therapy
- Harvard Health Publications: Symptoms of Endometriosis : Endometriosis Symptoms After Menopause
- Mayo Clinic: Breast Pain
