What is postmenopausal bleeding?

Postmenopausal bleeding is bleeding from your uterus after menopause. Menopause is the time when your ovaries stop releasing eggs and you stop having menstrual periods. It normally happens between the ages of 45 and 55. Menopause also happens if you have surgery to remove your ovaries.

If you have bleeding after menopause, you should contact your healthcare provider as soon as possible to find out the cause.

What is the cause?

Postmenopausal bleeding may be caused by:

• Hormone problems or hormone (estrogen) replacement therapy
• Some medicines, such as blood thinners
• Thinning and drying of the lining of the uterus or the vagina
• Polyps, which are growths on the cervix or inside the uterus
• Fibroids, which are noncancerous growths in the uterus
• Overgrowth of the cells in the lining of the uterus
• Infection of the cervix
• Cancer of the ovaries, uterus, cervix, or vagina

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

Tests may be done to find the cause of your bleeding. They may include:

• Blood tests
• Ultrasound, which uses sound waves to show pictures of the pelvic organs
• Hysteroscopy, which uses a small lighted tube put into your vagina, through the cervix, and into the uterus to examine the inside of the uterus. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing.
• Laparoscopy, which uses a small lighted tube put into the belly through a small cut to look at the organs and tissues inside the belly. A biopsy may be taken to help make a diagnosis.
• Hysterosalpingogram, which uses X-rays and a dye put into your vagina to show the uterus and fallopian tubes

Many of these procedures may be done in your healthcare provider’s office. Others may be done in an outpatient clinic.

How is it treated?

The treatment depends on the cause of the problem. For example, if you have a hormone imbalance, your healthcare provider may prescribe hormones.

Sometimes surgery is needed. Possible surgical treatments include:

• Dilation and curettage (D&C), which is a procedure for opening the cervix and then scraping or suctioning tissue from inside the uterus
• Hysteroscopy, which may be done to remove tissue, such as a polyp
• Hysterectomy, which is surgery to remove the uterus

If cancer is found, it may be treated with surgery, radiation, or chemotherapy (anticancer drugs).

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.