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Bleeding Even After Menopause? 5 Possible Reasons for Postmenopausal Bleeding and Why It Shouldn't Be Ignored

Bleeding Even After Menopause? 5 Possible Reasons for Postmenopausal Bleeding and Why It Shouldn't Be Ignored

Going to the doctor will help determine if the bleeding is caused by something benign or something more serious.

Menopause is the phase that marks the end of a woman's menstrual cycle. When a woman hasn't had her periods for 12 months or more, that point in time is marked as menopause. Some women face symptoms before it occurs and that's called the menopausal transition, or perimenopause. There is no set age for it and it can happen in your 40s or 50s. However, the average age is 51 in the United States, according to Mayoclinic.

Many women might experience bleeding after menopause and that can be concerning. It's usually not something to worry about and 90% of the time it's not caused by a serious condition, according to a study in JAMA Internal Medicine. But, if you do experience bleeding after your menopause you should see a doctor about it. Dr. Ross Berkowitz, William H. Baker Professor of Gynecology at Harvard Medical School said that it's important to see a doctor for it as the study also found one of the most common symptoms of endometrial cancer was postmenopausal bleeding. This type of cancer is highly curable when detected early.

There may be other causes of postmenopausal bleeding. Here are five possible reasons:

1. Vaginal atrophy

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This condition can be described as shrinking or thinning of vaginal tissue. The tissues of a woman's vagina no longer work normally when this happens, according to Cleveland Clinic. Menopause causes loss of estrogen, which keeps this tissue healthy. The low levels of estrogen make the vaginal walls thin, dry, and inflamed. Other symptoms of vaginal atrophy include burning and/or itching, pain during intercourse, and discharge. This could also affect the urinary system and lead to other symptoms like going to the bathroom often, pain when going to the bathroom, and urinary tract infections (UTIs).

2. Cancer

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Over the past 10 years, there has been an increase in cases of endometrial cancer. It affects 2-3% American women and is the most common type of gynecological cancer. Harvard Health quoted the American Cancer Society as saying that it affects postmenopausal women most often. The average age at diagnosis is 60. There are other types of cancer like uterine cancer, vaginal or cervical cancer, which cause bleeding too, according to WebMD.

3. Endometrial atrophy

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One of the causes of postmenopausal bleeding is the thinning of the uterine lining or endometrial atrophy. The endometrium is the tissue that coats the uterus. Hormones like estrogen and progesterone are important for the lining to stay healthy. When the hormone levels dip, as is the case in menopause, the lining can become too thin, which could cause bleeding, says WebMD. Endometrial atrophy is a benign condition, as per Harvard Health. It doesn't always need to be treated unless the atrophy causes vaginal bleeding after intercourse.

4. Endometrial hyperplasia

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The disturbance in the hormonal balance after menopause can also cause thickening of the uterine lining. For many women, menopause can lead to more estrogen and too little progesterone. This can cause the endometrium to get thicker and bleed. Sometimes, this can cause abnormal changes in cells in the endometrium leading to cancer. It's important to get this treated as soon as possible. It rarely occurs in women under the age of 35, says Cleveland Clinic. Other risk factors for endometrial hyperplasia includes never being pregnant, obesity, polycystic ovary syndrome (PCOS), thyroid disease, smoking, and family history.

5. Polyps 

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Polyps are abnormal tissue growth that look like small, flat bumps or tiny mushroomlike stalks. Most of them are benign and they could also show up inside the uterus or cervical canal, or on the cervix. It is usually not cancer but can cause spotting, heavy bleeding, or bleeding after intercourse, says Healthline. Seeing a doctor would help to clear up any doubts that you have about it as they would be able to do a biopsy by taking a small sample of the tissue for testing.

References:

https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2695509

https://www.health.harvard.edu/blog/bleeding-after-menopause-get-it-checked-out-2019011815809

https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy#

https://www.webmd.com/menopause/guide/postmenopausal-bleeding#1

https://www.health.harvard.edu/womens-health/abnormal-uterine-bleeding-in-peri-and-postmenopausal-women

https://my.clevelandclinic.org/health/diseases/16569-atypical-endometrial-hyperplasia#

https://www.healthline.com/health/polyps

Disclaimer : This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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