Postmenopausal bleeding refers to any vaginal bleeding that occurs after menopause. While many causes of postmenopausal bleeding are benign, bleeding after menopause should always be evaluated by a healthcare provider.
Postmenopausal bleeding can occur for many reasons. Some of the more common causes include:
• Vaginal or vulvar atrophy (Genitourinary Syndrome of Menopause/GSM)
• Hormone replacement therapy (HRT)
• Endometrial polyps
• Endometrial hyperplasia
• Fibroids
• Cervical polyps
• Infection or inflammation
• Endometrial (uterine) cancer
• Cervical cancer
• Bleeding from the bladder or rectum that may be mistaken for vaginal bleeding
Fortunately, many causes of postmenopausal bleeding are benign and treatable. However, because bleeding after menopause can occasionally be a sign of precancerous changes or cancer, evaluation is recommended for all patients experiencing postmenopausal bleeding. The purpose of the evaluation is to identify the underlying cause of the bleeding and determine whether additional testing or treatment is needed.
The resources below provide information about common causes of postmenopausal bleeding, diagnostic testing, and treatment options. I hope these materials help you better understand your symptoms and the available options for care.
Evaluation commonly includes a pelvic examination, ultrasound, endometrial biopsy, and occasionally hysteroscopy depending on the circumstances.