Postmenopausal Bleeding: What to Know About Spotting After Menopause

You made it to menopause — a whole year with no period. The changes your body is going through can take a little time to get used to, and the symptoms of menopause can last a while longer. But now you’re bleeding again? Is that normal?
Postmenopausal bleeding can have a range of triggers, but the important thing to do is seek medical advice. In most cases, bleeding after menopause is not a major cause for concern, but it’s one of those cases where the old saying, “better safe than sorry”, is definitely the one to remember.

So what do you need to know about spotting after menopause? Well, we’ve got the info.

In this article: 📝

What is considered postmenopausal bleeding?

Any vaginal bleeding after menopause (menopause is having at least 12 consecutive months without a period) is considered postmenopausal bleeding. So whether your periods stopped 15 months ago, or 15 years ago, it’s postmenopausal bleeding.

What is the most common cause of postmenopausal spotting?

Having a period after menopause can be alarming, but there’s not one most common cause. There’s a range of causes of postmenopausal spotting — not all of them serious — but all requiring a check-in with your doctor.

Causes of postmenopausal bleeding include:

• Polyps — these are non-cancerous tissue growths that can form anywhere in your cervix, uterus, or cervical canal.

• Endometrial Hyperplasia — This is the thickening of your uterine lining caused by an imbalance of hormones, specifically too much estrogen and not enough progesterone. Cells in the uterine lining can become abnormal, and can sometimes lead to cancer.

• Endometrial Atrophy — This is the thinning of the uterine lining, caused by very low hormone levels.

• Vaginal atrophy — This is the thinning of the vaginal walls, again, caused by low hormone levels experienced after menopause. The lining of the vaginal walls can become dry and inflamed, especially after sex.

• Cancer — Postmenopausal bleeding is the most common symptom of certain types of cancers, including endometrial, uterine, cervical, and vaginal cancers. Although serious, only around 9% of postmenopausal women who sought medical advice for vaginal bleeding were diagnosed with cancer. So you don’t have to assume the worst.

• HRT treatment — spotting can be a common side effect of Hormone Replacement Therapy which can be a common cause in itself for endometrial hyperplasia.

• Other factors — including STIs, medications, and vaginal infections.

And if it is something serious, the sooner you get a diagnosis, the better.

Can you spot after menopause?

Yes. As we’ve outlined above, there are various reasons for spotting after menopause. Most will require an examination or procedure to diagnose. Your doctor may refer to postmenopausal bleeding ICD 10, which is the International Classification of Diseases, regarding further testing or investigations they recommend.

Can stress cause spotting after menopause?

There are anecdotal suggestions that severe and prolonged stress caused by trauma, grief, or illness can trigger spotting after menopause, but there’s insufficient evidence for it to be included as a common medical cause.

Is bleeding during menopause normal?

Yes. Bleeding during the perimenopausal phase, before your periods completely stop, can be irregular in timing, length, and heaviness. It is your body’s way of adjusting to your reducing hormone levels.

What does postmenopausal bleeding look like?

Postmenopausal bleeding can be anything from a light spotting of brown, or black tinged discharge, some slight bleeding after sex, to a heavy flow of fresh red blood. No vaginal bleeding after menopause is normal, and all types require medical investigation.

📚 More on menopause:
Introducing, Peanut Menopause
What Happens During Menopause?
How to Deal With Menopause
When Does Menopause Start?
How Long Does Menopause Last?
Painful Sex After Menopause? What to Know
Are You Getting Cramps After Menopause?
What are the 34 Symptoms of Menopause?
What are the Signs Perimenopause is Ending?
Can You Get Pregnant After Menopause?
Testosterone Pellets for Women: What to Know