Vaginal Bleeding After Menopause

Imagine you’ve finally weathered the emotional storms and sweats and sleep deprivation of menopause and life has settled down to something resembling pre-menopause normality.  Your kids are out of the house, and you and your husband are getting used to  being a couple again.  Your career is enjoyable and you’re beginning to let yourself think and dream about retirement.

Your health is good and you feel well.  Then one afternoon during a trip to the bathroom you find an unpleasant and unexpected surprise.  Why are you bleeding again?  It’s been 3 years since your last menstrual period, this isn’t supposed to happen anymore!

What do you do?

Since I’m writing about it, it’s a safe bet the right answer is “Call and make an appointment with your doctor.”  There are a number of things that can cause vaginal bleeding after menopause, some of which are benign but a number of which are not.

Any vaginal bleeding after menopause is considered abnormal, even if it’s just a little brownish spotting.  It doesn’t need to be heavy enough to require a pantiliner or pad, it doesn’t even need to be heavy enough to stain your underwear.  Pink or brown discharge on toilet tissue after urinating should have you visiting the doctor to get checked out.

Bleeding from the vagina can come from one of 3 places.  These include the vagina and its outlet, the cervix and the uterus itself.  The patient’s report of symptoms and some testing will help figure out whether the cause is likely to be serious.

As I mentioned in a previous post, after menopause and the loss of the ovaries’ estrogen production, the tissues of the vagina and surrounding areas can become gradually thinner and more fragile.  Trying to have a romantic evening may cause a little trauma and some bleeding.  That’s not generally hard to figure out – a few pertinent questions will usually make that cause obvious.

If there’s no pain or evidence of trauma, we generally need to look at the ovaries and uterus with an ultrasound.  Thickening of the inner lining of the uterus or enlarged ovaries mean a visit to the friendly neighborhood gynecologist is in the near future.

If you or a woman you love has had vaginal bleeding after menopause, I want you to know that it should ALWAYS be checked.  Sometimes it’s just from an infection.  Sometimes it’s from something very serious, like ovarian or uterine cancer.

Please don’t wait.  Don’t panic, but don’t wait, call your doctor and get it checked out right away.