Is bleeding after menopause a "big deal"?

A common problem that I see in my office is abnormal bleeding...whether it is associated with puberty, the reproductive years or after the usual age of menopause (when the monthly periods completely stop). This article is going to concentrate on issues with bleeding AFTER menopause occurs.

Menopause is defined as having gone a full year without a menstrual cycle. Once this occurs, any amount of bleeding is considered abnormal. Some patients will have only a slight brown discharge or faint spotting while others may experience full blown bleeding. No matter the quantity of bleeding, this must be fully evaluated by a provider who is experienced in diagnosing and treatment this condition which is called postmenopausal bleeding.

Postmenopausal bleeding (PMB) may be due to many conditions. Thankfully, most of the causes are not worrisome, but, sometimes, there are worrisome things that can cause bleeding. The most common causes of PMB are things such as low hormone levels (which cause the vaginal and uterine tissues to be very fragile) or benign uterine polyps. More worrisome things may also be found to cause PMB. These conditions include cancer of the vulva (skin outside of the vagina), vagina, cervix or uterus.

What is involved in the exam? A pelvic exam is usually done to assess whether there are any obvious causes. If the causes seems to be coming from the uterus, a pelvic ultrasound may be ordered. This test is simple and painless. Most commonly, a probe is inserted into the vagina to be able to get a more detailed view of the uterus and ovaries. Sometimes the ultrasound may be done using a probe on the top of the abdomen or belly, but more details are seen using the vaginal probe.

If you have experienced any degree at all of minor spotting, brown (old blood) discharge or bleeding, call your healthcare provider to set up a time for further evaluation.