“After a year without a period, I have spotting.” Does this sound familiar?

Apr 22, 2024Madequa Health0 comments
Can you get your period after menopause? Find out more about bleeding after menopause and abdominal pain in this blog. Read more!
sangrado y estrés, sangrado en la menopausia, sangre

Postmenopause is the phase after menopause, when one year has passed since the last menstrual period. It marks the end of the fertile stage and the beginning of a new cycle. The symptoms of the previous stage (perimenopause) reduce in intensity until they disappear, but in this phase new symptoms associated with some diseases may appear that increase the risk of suffering from this stage of postmenopause.

Among these changes, vaginal bleeding after a year without menstruation can raise doubts and concerns.

Can menstruation decrease after menopause?

Generally, menopause is defined as the absence of menstrual bleeding for a full year. However, it is important to remember that every body is unique and some women may experience occasional or irregular bleeding even after postmenopause.

Vaginal bleeding after menopause, although not a normal physiological event, is an essential reason for a medical consultation. This phenomenon, which affects between 2% and 11% of postmenopausal women, can be caused by various reasons that require timely diagnosis and treatment.


What causes vaginal bleeding after menopause?

The causes of vaginal bleeding after menopause are diverse, and can be of both gynecological and non-gynecological origin.

Among the most common gynecological causes are:

  • Endometrial atrophy: Thinning and drying of the endometrium, the tissue that lines the inside of the uterus, is a common consequence of menopause. This condition can cause light, irregular bleeding, similar to "spotting."

  • Endometrial polyps, hyperplasia or cancer: These abnormal growths in the endometrium can cause irregular or heavy bleeding, often more intense than atrophy. Endometrial hyperplasia is characterized by excessive thickening of the endometrium, while endometrial cancer represents a malignant tumor that requires immediate medical attention.

  • Cervical disorders: Injuries or infections in the cervix, the opening to the cervical canal, can cause bleeding after intercourse or between menstrual periods. The most common causes include cervical erosions and cervical polyps.

  • Bacterial vaginosis: This common bacterial infection of the vagina can cause light bleeding, abnormal vaginal discharge with an unpleasant odor, and itching or burning in the genital area.

We also observe other types of bleeding, the origin of which often causes confusion in women. However, they have other causes, such as:

  • Hemorrhoids: Swollen veins in the anus that may bleed during or after bowel movements, usually manifesting as blood on toilet paper or in the toilet bowl.

  • Urinary tract infections: Bladder or kidney infections can cause blood in the urine, which may be pink, red or orange in color and may be accompanied by burning when urinating, frequent urge to urinate and discomfort in the lower abdomen.

  • Blood clotting disorders: Conditions such as hemophilia or von Willebrand disease, which impair the ability of blood to clot, can increase the risk of abnormal bleeding throughout the body, including vaginal bleeding.

  • Medications: Certain medications, such as blood thinners to prevent blood clots or hormone therapy for menopause, can cause irregular bleeding as a side effect.

When should I worry about vaginal bleeding after menopause?

While vaginal bleeding after menopause is not always a cause for alarm, it is important to pay attention to certain signs that could indicate a more serious condition:

  • Heavy or prolonged bleeding: If bleeding is heavier than spotting or lasts more than a few days, it is important to consult a gynecologist.
  • Bleeding accompanied by abdominal pain, discomfort, or foul-smelling discharge: These symptoms may indicate an infection or a more serious problem in the reproductive system.
  • Bleeding after menopause and no history of previous bleeding: If you have never experienced bleeding after menopause, it is important to consult with a gynecologist to rule out any underlying causes.

Risk factors

  • Recent menopause: Vaginal bleeding is more common in the first few years after menopause, due to the hormonal changes the body experiences.
  • Hormone therapy: Menopausal hormone therapy, which combines estrogen and progestin, may increase the risk of vaginal bleeding, especially during the first few months of treatment.
  • Obesity: Women who are overweight or obese are at increased risk for abnormal endometrial bleeding, as excess body fat can disrupt estrogen and progesterone levels.
  • History of cancer: Women with a history of endometrial cancer or other gynecologic cancers are at higher risk for abnormal vaginal bleeding and require closer medical follow-up.

What should I do if I experience vaginal bleeding after menopause?

Between 6 and 20% of vaginal bleeding in postmenopause is due to a malignant cause . If you experience vaginal bleeding after menopause, the most important thing is to consult a gynecologist to determine the cause of the bleeding and receive appropriate treatment.

Vaginal bleeding in postmenopause, while it may be an indication of a serious condition, is not always a cause for alarm. However, it is essential that you consult a gynecologist for a proper diagnosis and treatment.

Remember:

  • Having regular gynecological visits at least once a year is essential for early detection and timely treatment of any health problem, including abnormal vaginal bleeding.
  • Maintaining a healthy lifestyle through diet and regular exercise can help reduce the risk of abnormal endometrial bleeding.
  • Hormone therapy: Talk to your gynecologist about the risks and benefits of hormone therapy if you are considering using it for menopause. Your doctor will help you determine the most appropriate option for your particular case and will advise you about possible side effects, including vaginal bleeding.

If you identify with any of the points in this blog or would like to know more about the topic → read the following blog and find out or take our test.

References:


  • MSD Manuals (2021, August 2). The Uterus, Cervix, and Cervical Canal .






















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