Bleeding after menopause, also known as postmenopausal bleeding (PMB), can be concerning but is not always caused by cancer. Potential causes range from benign polyps to more serious issues like endometrial cancer.
Causes
Some common causes of bleeding after menopause include:
- Polyp or other benign growths (non-cancerous) in the uterus or cervix
- Thinning of vaginal walls (vaginal atrophy) from low estrogen levels
- Endometrial hyperplasia - overgrowth of the uterine lining. May lead to cancer.
- Endometrial cancer - most common pelvic cancer in women after menopause
- Infection of the vagina or cervix
- Trauma to vaginal walls during intercourse
Benign causes like polyps, atrophy, and hyperplasia are far more common than endometrial cancer. However, it's still crucial to inform your doctor about any postmenopausal bleeding.
Assessment and Diagnosis
To determine the cause of postmenopausal bleeding, your doctor will likely:
- Do a pelvic exam to check for abnormalities in the uterus, cervix, or vagina
- Order imaging tests like an ultrasound or biopsy
- Perform endometrial tissue sampling to test for cancer or abnormal growths
Finding the cause is essential to guide appropriate treatment and followup.
Treatment
- If excessive bleeding or endometrial abnormalities are found, surgery (D&C, hysteroscopy, hysterectomy) may be recommended
- Hormone therapy for those with vaginal atrophy may help relieve low estrogen symptoms
- Follow-up care is individualized based on test results
The good news is that most cases of PMB are ultimately found to be benign or cancer precursors that are treatable if detected early through screening.
Postmenopausal bleeding should never be ignored. Inform your physician,
as timely evaluation and treatment can lead to favorable outcomes even if cancer is detected. Stay on top of women's health screenings and report any unusual symptoms promptly.