Common causes of postmenopausal bleeding can be rather serious or quite innocuous.  Some 30% of postmenopausal women will go 12 months without a menstrual period and then experience some bleeding at one time or another.  While the causes of this phenomenon can be simple, there are some more serious possibilities.  For this reason, this symptom should be promptly reported to a gynecological specialist and a woman should be examined and any required testing should be undertaken promptly.  Women who have had less than 12 months free from menstrual periods have likely not passed all the way through menopause, but should still consult a physician if their bleeding is irregular, extremely heavy or in any other way truly concerning them.  There are several common causes of postmenopausal bleeding; the following are some of the most common.

Imbalance of Hormones

Bleeding often occurs when a woman who is on hormone replacement therapy changes her dosage, misses some of her medication, or decides to wean off of the prescribed medication.  Adding progesterone, the common hormone used for replacement therapy, in any form will cause a woman who has a buildup of endometrial tissue in her uterus to experience spotting or in the case of a large build up some heavier bleeding.  Progesterone is not causing a problem and will not continue to cause bleeding once this excess buildup has been shed.  The hormone is simply allowing the uterus to shed the unneeded excess that was present before the therapy began.  Ongoing bleeding while undergoing this therapy is often stopped simply by having a healthcare professional adjust the dosage of hormone the patient is taking.

Drastic Weight Loss

For a woman who loses a great deal of weight, due to dietary changes, illness or gastric bypass surgery there can be some occurrences of postmenopausal bleeding.  The reason this occurs is that there is estrogen, a female hormone, stored in the body fat.  As the body fat reduces chemicals stored in it such as this hormone re-enter the blood stream throwing off the body’s balance and causing temporary changes.  Because of issues such as this, doctors recommend gradual weight loss if at all possible.  With a more gradual reduction in body fat the levels of the hormones do not become so drastically changed and the likelihood of postmenopausal bleeding is greatly reduced. 

Polyps and Uterine Fibroids

These two benign types of growths can both causes bleeding in postmenopausal women. Polyps may be found in the uterus or in the cervix and can bleed and may need to be removed.  These are noncancerous growths that may cause bleeding.  Uterine fibroids, or fibroid tumors, are very common and often begin to cause problems during the period of time just before a woman enters menopause.  While some women experience a reduction in the size a severity of these benign tumors, others will continue to experience bleeding from them throughout menopause.  Fibroid tumors are sometimes removed and many women have hysterectomies because of pain and bleeding from their fibroids.  A percentage of women with fibroids do not have serious symptoms and require no treatment of the tumors.  Women who experience cramping, recurrent postmenopausal bleeding, aching or other fibroid symptoms need to seek professional treatment.

Atrophic Vaginitis

As a woman ages and reaches her menopausal years, the amount of estrogen produced in her body decreases.  Because of this phenomenon women often experience what is known as atrophic vaginitis.  This condition involves atrophy and thinning of the vaginal lining. This is the most common cause of spotting or bleeding in postmenopausal women.  Bleeding often occurs after sexual activity with this condition although it may occur during other times as well.  This condition can be problematic and uncomfortable and can set a woman up for frequent yeast infections.  It is generally treated with hormonal creams or vaginal lubricants or moisturizers.  While some women find relief with their first treatment, others often have to try several different creams or dosages or lubricants or even a combination before relief is achieved.

More Serious Problems

Uterine cancer and precancerous conditions will also cause postmenopausal bleeding.  In nearly 90 of all cases of this form of cancer bleeding occurs fairly early.  For this reason, among many others, it is vitally important to have all postmenopausal bleeding, including even lightly tinted discharge, which is pink from very small amounts of blood, checked by a gynecological specialist right away.  Precancerous conditions can be monitored and hysterectomies can be performed if necessary.  Because this is often an early symptom of these conditions, women who do not hesitate and have their health status checked quickly will have good odds of having successful cancer treatment.  Again, it cannot be stressed enough that all postmenopausal bleeding should be checked promptly so as to increase the chances of a complete and full recovery if there proves to be a cancerous condition present.  Precancerous conditions can often be monitored through regular screening tests, examinations in the doctor’s office and radiological studies.  Often, a woman will opt to have a full hysterectomy to avoid the possibility of later having to deal with cancer.  Other reproductive system cancers such a cervical and ovarian cancer may also cause postmenopausal bleeding; again, because these are such serious illnesses it is vital to be screened for these conditions if bleeding occurs following menopause.

The likelihood that a woman will experience some form of postmenopausal bleeding is about 3 out of ten.  Although the majority of women with this symptom have treatable and relatively minor issues, there are a few very serious conditions that can also be present. Women who are experiencing bleeding of this nature need to seek medical attention to be sure that no serious condition has or is about to develop.  Because the more serious causes of postmenopausal bleeding can lead to the need for long term medical care, a great deal of pain and discomfort, disability or even in the most serious cases death, especially when this symptom is ignored, it is imperative that a woman have regular gynecological visits after menopause and that she immediately report and seek attention for even what might be slightest causes of postmenopausal bleeding.