Menopausal Bleeding After 10 Years - When Should You Worry?

Menopause is supposed to be a time of transition, of creating a new balance. That's what we've been told, right? But the truth is that menopause comes with many changes: some expected, some more surprising. The appearance of bleeding after menopause can be one of the less expected changes.

What does bleeding during menopause mean? Is it normal? Is it a warning sign? Let's understand everything together. Here's why bleeding after menopause can occur, and why it's important to always discuss it with your doctor.

What is menopausal bleeding?

Menopausal bleeding refers to any vaginal bleeding that occurs after menopause is confirmed. It can be light bleeding (spotting), or it can be heavy bleeding that requires the use of menstrual products .

If you are going through menopause, you should talk to your doctor immediately about any kind of bleeding to quickly identify the cause and find out early if there is any cause for concern.

When is menopause confirmed?

Menopause is the time when your menstrual cycle stops and your periods stop. But because your last periods can be very irregular, stopping and starting again every few months, menopause is only confirmed when 12 months have passed since your last period.

Any bleeding that occurs after this time period is defined as postmenopausal bleeding and requires medical attention.

Menopausal Bleeding - Causes - Associated Conditions

Most of the time, menopausal bleeding is a sign of minor problems. In only 10% of cases, it signals the presence of cancer.

However, it is recommended to see a doctor about any type of postmenopausal bleeding to make sure you are not suffering from a serious condition and your body is safe. Among the most common causes and conditions associated with postmenopausal bleeding are:

• Atrophic vaginitis (inflammation and thinning of the vaginal mucosa, as a result of low estrogen levels)
• Thinning of the uterine lining
• Uterine polyps (growths on the uterus or cervix, usually noncancerous)
• Endometrial hyperplasia (thickening of the endometrium and the possible presence of abnormal cells, often as a result of hormone replacement therapy)
• Abnormalities in the cervix or uterus
• Endometrial cancer

Is menopausal bleeding normal?

Although many times, bleeding does not have a serious cause and is rather caused by harmless factors or problems that are easily treated, bleeding during menopause is not normal. Any kind of bleeding, whether spotting, light pink or brown bleeding, or heavy bleeding, is unusual. Even those that only occur 1-2 times.

Talk to your doctor if you ever notice such bleeding after confirming menopause, as it can be a sign of a medical condition. It is important for your doctor to recommend the necessary investigations, identify the cause, and prescribe the right treatment in advance.

Postmenopausal bleeding - How is the diagnosis made?

To determine the cause behind menopausal bleeding, your gynecologist may recommend the following investigations:

• Examination of the vagina and cervix, as well as the cervix.
• Babeș-Papanicolau test , to identify the possible presence of abnormal cells in the cervix.
• Transvaginal ultrasound
• Endometrial or uterine biopsy, to collect and examine cells from the uterine lining.

In addition to the actual investigations, the doctor will also analyze your medical history, asking you questions about how long it has been since your last period, whether you suffer from other conditions, and what treatments you are taking.

Menopausal Bleeding - Treatment Options

Because there can be multiple causes behind vaginal bleeding during menopause, treatment will be recommended depending on the condition that caused it. Drug treatments may be administered in the case of infections, hormonal treatments if the bleeding is related to decreased estrogen levels, or surgical treatments in certain specific situations.

Drug treatment

Drug treatment for postmenopausal bleeding may consist of:

• Antibiotics, if the bleeding is the consequence of an infection.
• Estrogen , which can be administered in the form of pills, creams, or ovules in the case of atrophic vaginitis.
• Progestin, which can be administered in the form of pills, injection, cream, or an intrauterine device, to treat endometrial hyperplasia.

Surgical treatment

In the case of more severe conditions, when drug treatment does not work effectively, the doctor may recommend surgical intervention:

• Hysteroscopy, for diagnosing and treating uterine polyps or other growths that cause bleeding.
• Dilation and curettage, which may be performed along with hysteroscopy to remove the uterine lining and contents of the uterus in certain types of endometrial hyperplasia.
• Hysterectomy, performed in cases of uterine cancer, to remove the uterus and cervix.

Postmenopausal bleeding - Prevention

Not all causes of postmenopausal bleeding can be prevented. It is difficult to prevent, for example, hormonal changes or conditions that occur with age.

What you can do, however, is implement healthy habits to reduce the risk of gynecological problems and, automatically, the risk of bleeding and other abnormal symptoms after menopause.

Recommendations for gynecological health during menopause

Use menopause as an opportunity to prioritize your intimate health, and beyond. Rethink your relationship with your body and try to maintain a healthy lifestyle to avoid the onset of gynecological or other problems.

Try to modify your diet by introducing as many nutritious foods as possible, such as fruits, vegetables, sources of fiber, and unsaturated fats, to support hormonal balance and uterine health.

Other lifestyle habits are just as important. Regular physical activity, hydration, rest, and avoiding alcohol and tobacco use also help reduce the risk of health problems.

And, of course, always listen to your body. Go to every routine gynecological check-up. Talk to your doctor about any unusual bleeding, from the first signs. Follow your doctor's recommendations and perform the necessary tests and screenings: Pap smear, transvaginal ultrasound, hormonal tests. Take care of your body, as you deserve.

Frequently asked questions about menopausal bleeding

At the end of the article, we want you to be left with this thought: menopause is not a break from your health. It is a new stage of life, the beauty of which you deserve to enjoy.

So allow yourself to ask questions and seek answers, to be prepared for any situation. Because we want to be there for you, we have prepared some of the most frequently asked questions about menopausal bleeding below, along with clear answers.

Is it normal to have bleeding during menopause?

No. After menopause is confirmed (at least 12 months since the last menstruation), although the causes are often harmless, any vaginal bleeding is a warning sign and requires medical attention.

Can hormone replacement therapy cause menopausal bleeding?

Yes, sometimes hormone replacement therapy can cause vaginal bleeding, especially in the first few months of treatment. If the bleeding is heavy, persistent, or occurs later, talk to your doctor. He or she may adjust your dose or recommend another treatment.

Can menopausal bleeding be prevented?

Not all conditions that can cause menopausal bleeding can be prevented. But an active and healthy lifestyle, a nutritious diet, sufficient rest, and regular gynecological check-ups can reduce the risk of many conditions and complications.

How often should gynecological check-ups be done during menopause?

As a rule, gynecological checkups should be done at least once a year, even after menopause sets in. However, your doctor may recommend more frequent checkups depending on your medical history.

Are there effective natural treatments for menopausal bleeding?

Some natural treatments may help relieve symptoms, but they do not replace gynecological check-ups. If the bleeding is caused by a health problem, it is essential to find out the exact cause and treat it appropriately, as recommended by a specialist.

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