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More about Postmenopausal Bleeding:
Definition Causes and symptoms Diagnosis Treatment Prognosis Prevention Resources |
Postmenopausal bleeding can originate in different parts of the reproductive system. Bleeding from the vagina may occur because when estrogen secretion stops, the vagina dries out and can diminish (atrophy). This is the most common cause of bleeding from the lower reproductive tract.
Lesions and cracks on the vulva may also bleed. Sometimes bleeding occurs after intercourse. Bleeding can occur with or without an associated infection.
Bleeding from the upper reproductive system can be caused by:
- hormone replacements
- endometrial cancer
- endometrial polyps
- cervical cancer
- cervical lesions
- uterine tumors
- ovarian cancer
- estrogen-secreting tumors in other parts of the body
The most common cause of postmenopausal bleeding is HRT. The estrogen in the replacement therapy eases the symptoms of menopause (like hot flashes), and decreases the risk of osteoporosis. Sometimes this supplemental estrogen stimulates the uterine lining to grow. When the lining is shed, postmenopausal bleeding occurs. Most women on HRT usually take the hormone progesterone with the estrogen, and may have monthly withdrawal bleeding. This is a normal side effect.
About 5–10% of postmenopausal bleeding is due to endometrial cancer or its precursors. Uterine hyperplasia, the abnormal growth of uterine cells, can be a precursor to cancer.
— Tish Davidson
