Don’t Ignore Postmenopausal Bleeding!

As a urogynecologist and hormone expert with over 2 decades of experience, I’ve seen it all. And when it comes to postmenopausal bleeding, I’m here to tell you—don’t ignore it. Many women, myself included, are more than ready to be done with tampons, pads, and periods. But when that irregular bleeding happens after menopause, it's tempting to brush it off. It’s easy to dismiss it as just a nuisance or assume it’s “nothing to worry about.”  However I never recommend that you ignore any postmenopausal bleeding, no matter how light or how annoying it may seem. Reporting it to your healthcare provider could literally save your life.

What Is Postmenopausal Bleeding?

Postmenopausal bleeding is any bleeding that happens after menopause. It can be anything from a few brown spots on your underwear, even ten years after your last period, to weekly spotting for the past couple of months, or a sudden gush of blood after sexual intercourse. If you're postmenopausal, any kind of bleeding is cause for attention.

How Do You Know If You’re Postmenopausal or Perimenopausal?

This is a common question for many midlife women—and it can be tricky. The transition to menopause is called perimenopause, and it can last for several years. Menopause is officially defined as the point when you haven’t had a period for 12 consecutive months. If your period stops for six months, and then you experience bleeding, the clock starts over.

Isn’t Irregular Bleeding Normal During Perimenopause?

Yes, it’s true that irregular bleeding is common during perimenopause. In fact, around 90% of women experience changes in their menstrual cycles during the 4 to 8 years leading up to menopause. But here’s the key: even though changes are normal during perimenopause, abnormal bleeding still needs to be evaluated. The American College of Obstetricians and Gynecologists (ACOG) and the North American Menopause Society (NAMS) agree that any irregular bleeding should be checked out.

The Link Between Postmenopausal Bleeding and Endometrial Cancer

Here’s the part that worries all women’s health providers—endometrial cancer. This cancer starts in the lining of your uterus, called the endometrium, and it’s the most common cancer of the female reproductive organs. Endometrial cancer is most often diagnosed in women in their 60s, but it can happen earlier, especially in women who have gone through menopause.

During perimenopause and postmenopause, changes in estrogen and progesterone can cause the endometrium to thicken. When there’s too much estrogen or not enough progesterone to balance it, the endometrium can grow excessively, and in some cases, that thickening can lead to cancer. Women with higher body fat are at greater risk, since fat tissue produces estrogen, which can further stimulate the growth of the endometrial lining.

As the lining thickens, it becomes unstable, and can shed, causing bleeding. In fact, 90% of women with endometrial cancer report bleeding before they’re diagnosed. But keep in mind—just because you have postmenopausal bleeding, it doesn’t mean you have endometrial cancer. But it all needs to be evaluated.

Why Postmenopausal Bleeding Can Be an Early Warning Sign

The good news is, if endometrial cancer is caught early, it’s extremely treatable. The most common treatment is a hysterectomy, and if caught early, women have a 95% chance of surviving for at least five years. That’s why I urge every woman to take notice of any irregular bleeding and report it to your healthcare provider. It could save your life.

How Do Healthcare Providers Check for Abnormal Bleeding?

When you report irregular bleeding, your healthcare provider will usually start by ordering a transvaginal ultrasound. During this procedure, a small, wand-like device is inserted into the vagina to measure the thickness of your endometrial lining. If the lining looks too thick (more than 4 millimeters), they may recommend an endometrial biopsy. This is a simple, in-office procedure that samples your endometrial tissue to check for any pre-cancerous changes.

Why You Shouldn’t Ignore Postmenopausal Bleeding

It’s tempting to ignore that little bit of bleeding—after all, you’re done with periods, right? But don’t let that temptation win. Women who experience postmenopausal bleeding should always have it evaluated as soon as possible. I can’t stress this enough. Too many women don’t know about the link between postmenopausal bleeding and endometrial cancer, and they miss an opportunity to catch something early. So, take what you’ve learned here and share it with your friends, family, and loved ones. By helping each other, we can all live healthier, happier lives.

So, if you experience any postmenopausal bleeding, don't wait. Reach out to your healthcare provider and get it checked out. It could make all the difference.

For more tips and resources, visit our website. Together, we can make sure that every woman gets the care she needs and deserves.

Listen to Dr Jackson go into detail about this topic!  You can hear the full episode on her podcast, Ageless and Outrageous.  Be sure to like and follow so you don’t miss an episode!

https://agelessandoutrageous.alitu.com/

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