Postmenopausal bleeding is defined as any form of vaginal bleeding that occurs at least one year after the end of normal menstruation bleeding. Read on for a clear, simple explanation of the possible causes.


The common causes of postmenopausal bleeding are benign (non-cancerous) conditions such as cervical polyps, vaginitis or atropic endometritis.

Cervical polyps

These are common benign tumors or polyps on the surface of the cervical canal. They most commonly occur for post-menstrual and pre-menopausal women who have been pregnant at some time in their lives. They are usually easily removed. Note that cervical polyps might cause bleeding, but it's not uncommon for no symptoms to show up at all.


Vaginitis is an inflammation of the vagina usually caused by an infection. Symptoms may include a foul vaginal odor, discomfort when urinating, pain during sexual intercourse, swelling, irritation or itching of the genital area. The infection may be fungal, allergic or other. Treatment depends on the cause of the infection.

In some cases however, the postmenopausal bleeding may be caused by cervical cancer or endometrial carcinoma.

Cervical cancer

Cervical cancer may not show any symptoms at all until the cancer is at an advanced stage. Vaginal bleeding, bleeding during intercourse and vaginal discharge may be symptoms and in advanced cases symptoms of cervical cancer may include weight loss, fatigue, loss of appetite, back pain, urine or feces leading, leg pain and others.

Endometrial cancer

Enometrial cancer refers to several cancers coming from the endometrium, otherwise known as the lining of the uterus. In the US alone, over 30,000 women are diagnosed with endometrial cancer a year. The most common type occurs within a few decades after menopause.

What to do if you're experiencing postmenopausal vaginal bleeding?

You should go to your gynaecologist for a uterine cavity examination. They will probably give you a transvaginal ultrasonograph, endometrial biopsy and/or a hysteroscopy.

Transvaginal ultrasonography measures the thickness of endometrial tissue. An increase in the thickness of endometrial tissue is linked with uterine pathology. If the endometrium is thicker than 5mm, usually a endometrial biopsy and/or hysteroscopy is usually undertaken. Endometrial biopsy is a straightforward procedure that does not require anaesthesia. Tissue is collected from inside the uterine cavity through the insertion of a small tube through the cervix.

A visual assessment of the uterus is made through a hysteroscope, sometimes with anaesthesia. Hysteroscopy might confirm any transvaginal ultrasound findings and remove polyps if necessary. If there are any suspect endometrial reas, a directed endometrial biopsy may be conducted via the hysteroscope.

As with all health conditions, the earlier you see a health professional, the better.