Causes of Bleeding After Menopause

Tamsen Butler
Medical review by Terri Forehand RN
Doctor and senior patient reviewing medical chart

You should always bring bleeding after menopause to the attention of your physician to screen for potential medical issues. While it's not always a tangible sign of something serious, it's not something to ignore either.

Menopause

The actual cessation of menstruation can take a long time - sometimes many years. Bleeding during menopause can be normal as the body works to regulate itself into a new normal. Bleeding after menopause is not considered normal and indicates bleeding after periods have stopped for at least one full year after the age of 45. Bleeding after menopause can be similar to a period in the sense that it can be light or heavy, with varying color shades and at times may even present in a clot.

Common Causes

Bleeding after menopause is not always an indication of something serious, but it is something that merits a trip to your physician since the cause of bleeding might be easily treatable.

Menstruation

Monthly cycles may become sporadic as a woman enters menopause, so it's not unusual for a woman to assume she's finished with her periods and into menopause after a few months have passed without a period. When the period returns, it can be jolting to a woman as she isn't expecting it, but it's always possible the return of monthly periods indicate that menopause has not yet occurred.

Spontaneous Ovulation

Harvard Medical School says "rogue ovulation" in post-menopausal women can happen even after it's been a year or more after periods stop. While Harvard declares these instances "harmless," it's still important to schedule a physician's visit when any bleeding after menopause happens.

Low Estrogen

After menopause, lower estrogen levels can potentially result in the thinning of vaginal tissue. This thinning makes the vagina more apt to become dry, making the friction of intercourse cause irritation that can lead to bleeding; a doctor might suggest lubrication before sex to avoid this issue. This thinning can also cause bleeding without intercourse as the lining of the uterus becomes thinner from lack of estrogen and bleeds as a result.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy can prompt bleeding as the body adjusts to the new balances of hormones. Bleeding may be light or might rival your periods pre-menopause.

Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases that had gone undiagnosed for years may be the culprit when it comes to bleeding after menopause, particularly if it occurs after intercourse says WebMD. In this instance, treatment of the STDs may stop the instances of bleeding.

Other Conditions

Other, less common conditions may be responsible, as well.

Fibroids

Fibroids in the uterus are one cause of bleeding after menopause. Fibroids can generate the thickening of uterine walls associated with menstruation. These benign growths can slough off and cause spotting or bleeding. Your doctor may recommend birth control pills or surgery to treat the fibroids.

Cancer of the Uterus

Though bleeding after menopause can be a sign of cancer, a cancer diagnosis is not the most common reason for bleeding post-menopause. Cancer of the uterus attacks the lining of the uterus or endometrium. The cause of uterine cancer is an imbalance of the hormones estrogen and progesterone within a woman's body. The endometrium thickens as a result. Treatment for uterine cancer can involve surgery, chemotherapy, radiation, hormone replacement therapy, or a combination of these.

The Ever-Changing Body

Menopause can already be a confusing time for women, so when bleeding starts it can be alarming. Visit a doctor, who will diagnose and treat the cause, whatever that may be.

Causes of Bleeding After Menopause