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Post-Menstrual Vaginal Bleeding  

Menopause is diagnosed in women who have not had a period for one year. Usually occurring after age 45, menopause signals the end of a woman’s reproductive years and is characterized by a drop in estrogen and progesterone hormones.  

Vaginal bleeding after menopause is not normal and should be promptly evaluated by a medical professional. This bleeding can range from occasional spotting to a heavy flow, similar to a period. While it’s often harmless and easily treated, post-menstrual bleeding is also a possible symptom of many gynecological cancers.  

Post-Menstrual Bleeding Causes     

There are several medical conditions that are linked to vaginal bleeding after menopause:  

  • Vaginal atrophy – This thinning of vaginal tissue is linked to reduced estrogen levels that result from menopause.  
  • Endometrial atrophy – Just as vaginal tissue can thin after menopause, so can the endometrial tissue that lines the uterus.  
  • Endometrial hyperplasia – Menopause may also lead to a thickening of endometrial tissue (hyperplasia) that can lead to vaginal bleeding.  
  • Polyps – Small, non-cancerous tumors called polyps can grow in the uterus or cervix and cause vaginal bleeding.  
  • Sexually transmitted infections (STIs or STDs) – Gonorrhea and chlamydia are associated with vaginal bleeding after sex.  
  • Cancer – Vaginal bleeding is a symptom of several gynecological malignancies, including uterine, endometrial, vaginal and cervical cancers.  

Vaginal bleeding may also be a side effect of certain medications, such as blood thinners and hormone therapies. The only way to know what is causing your symptoms is to speak with your general practitioner or OB/GYN, who will evaluate your condition and may suggest certain diagnostic tests.  

Post-Menstrual Bleeding Diagnosis

There are multiple tests that can be used to diagnose the cause of vaginal bleeding after menopause. Based on your symptoms and medical history, your physician may recommend:  

  • An endometrial biopsy to collect a small tissue sample  
  • A transvaginal ultrasound to view images of the pelvic area  
  • A hysteroscopy to view the inside of the uterus using a thin, lighted tube 
  • A sonohysterography to measure the size of a polyp using ultrasound technology  

Post-Menstrual Bleeding Treatments    

Tampa General Hospital’s Women’s Institute provides a full scope of diagnostics and treatment to women with post-menstrual bleeding. Each woman’s care plan will vary according to the cause of her symptoms, but common treatment approaches include: 

  • Hormone therapies to address tissue thinning or thickening   
  • Minimally invasive procedures to remove polyps  
  • Surgery to remove reproductive organs  
  • Cancer therapies to treat gynecological malignancies