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Is Postmenopausal Bleeding Normal?

Bleeding or spotting occurring after a woman has undergone menopause is known as postmenopausal bleeding. 

Spotting or bleeding after menopause is not normal. Postmenopausal bleeding is generally an indicator of health problem hence it is essential that the woman visits her physician on noticing postmenopausal vaginal bleeding.


There are certain conditions which can give rise to postmenopausal bleeding. Some of the common causes of postmenopausal bleeding are as follows:

  • Use of HRT.
  • Clotting diseases.
  • Thyroid disorders.
  • Emotional stress. 
  • Endometrial cancers. 
  • Endometrial atrophy.
  • Bleeding from the urinary tract.
  • Growth in uterus or cervix (polyps)
  • Abnormalities in the cervix or uterus.
  • Endometritis (Infection of the uterine lining).
  • Thickening of the endometrium (endometrial hyperplasia).


Majority of the women suffering from postmenopausal symptoms may have no other symptoms apart from bleeding. The appearance of additional symptoms is dependent on the cause of bleeding.

Some of the symptoms experienced by postmenopausal women are:

  • Insomnia.
  • Weight gain.
  • Mood swings.
  • Vaginal dryness.
  • Reduced sexual drive.
  • Pain in the pelvic region. 
  • Increased urinary tract infections.
  • Sudden changes in the bowel movements.


Postmenopausal bleeding can be diagnosed through the following procedures:

  • Hysteroscopy.
  • Medical history.
  • Endometrial biopsy.
  • Sonohysterography. 
  • Physical examination.
  • Transvaginal ultrasound.
  • Pap smear, to screen cervical cancer.

  • Treatment of postmenopausal bleeding is dependent on the cause & amount of bleeding. It is also based on the presence of additional symptoms. 
  • Though, in few cases, there may be no requirement of any treatment. 
  • When detected early, most causes of postmenopausal bleeding (including cancer) can be successfully treated.

Some of the treatment recommended based on the cause, is as follows:

  • Medications.
  • Hysterectomy.
  • Removal of the polyp.
  • Progestin, if the endometrial tissue is overgrown.
  • Diet rich in iron; zinc; omega 3 & vitamin A, C, D & E.
  • Estrogen creams, cream if bleeding is due to thinning of vaginal tissues.
  • If cancer is the cause of bleeding then, treatment shall be based on the stage & type of cancer. Common treatment for cancer includes surgery, chemotherapy, and radiation therapy.

  • Generally, postmenopausal bleeding is successfully treated. 
  • If the cause of postmenopausal bleeding is cancer then, the outlook shall be dependent on the stage & type of cancer. 


Some of the preventive methods which can be adapted are as follows:

  • Maintaining a healthy body weight.
  • Practicing safe sexual intercourse to avoid sexually transmitted diseases.
  • Regular checkups with gynecologists to make sure that the uterus is healthy.
  • Maintaining hygienic measures during menstruation which shall decrease the chances of infection.

Bleeding after attaining menopause is not normal and may indicate some serious problem. Hence, in order to prevent serious medical conditions such as cancer, postmenopausal bleeding should not be neglected and should be identified and treated in time. Hygienic practices should be adapted to prevent the symptoms. 

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