What causes bleeding after menopause and how to treat it Is it dangerous all the time?

Bleeding or spotting after menopause is usually caused by harmless changes in the genital tract, but can indicate cancer in some women.

Bleeding after menopause is a condition that requires urgent medical attention, usually occurs around the age of 50. If there is no bleeding for 12 months, the woman has entered the postmenopausal period. Bleeding and spotting that occur one year after the last menstrual period are not normal.

Learn more at Bleeding after menopause is not always dangerous, but it should never be ignored

Bleeding after menopause – causes

  • hormone replacement therapy 
  • ovarian cysts 
  • uterine fibroids 
  • uterine polyps: 
  • atrophic vaginitis 
  • atrophic changes of the endometrium (uterine mucosa) 
  • Vaginal and/or uterine prolapse 
  • cancer of the vagina , cervix or body of the womb (endometrium). 
  • blood diseases, incl. bleeding disorders , e.g. hemophilia or von Willebrand disease
  • taking certain medicines, e.g. anticoagulants

Bleeding after menopause: diagnosis

In the case of bleeding or spotting after menopause, you should visit a gynecologist who should perform the following tests:

  • cervical examination
  • Transvaginal ultrasound
  • Magnetic resonance imaging of the pelvis (performed if changes are detected in the ultrasound examination)
  • Hysteroscopy – a study that allows you to assess the condition of the inner walls of the uterus
  • biopsy of the lining of the womb (endometrium)
  • histopathological examination of the collected fragments of the uterine mucosa

Treatment for bleeding following menopause

How you treat bleeding after menopause depends on what’s causing it. In the case of atrophic vaginitis, for example, hormone replacement therapy is used to make up for the lack of estrogen. When the atrophy isn’t too bad, moisturizers and lubricants work well. If bleeding after menopause is caused by uterine fibroids, painkillers or anti-inflammatory drugs are used, and in some cases, hormonal drugs are used. They can also be taken out through surgery.


Uterine fibroids are the most common benign tumors in women

Uterine fibroids are the most common benign tumors in women, often developing asymptomatically and causing abnormal vaginal bleeding or difficulties in pregnancy.

Uterine fibroids are benign growths of the uterine lining. This is an extremely common occurrence. Fibroids are thought to affect 50-60% of women. Fibroids are caused by a combination of factors, including perimenopausal age, genetic factors, black race, menarche before the age of 12, obesity, high blood pressure, and a diet high in red meat, alcohol, and caffeine.

The signs of uterine fibroids

Clinical signs of uterine fibroids occur in less than half of women.It is estimated that 30-40% of women with fibroids complain of symptoms such as:

  • abnormal bleeding (heavy periods, breakthrough bleeding that can lead to iron deficiency anemia ),
  • abdominal pain ,
  • abdominal pressure,
  • a feeling of fullness in the pelvis,
  • urge to urinate,
  • frequent urination at night (nocturia)
  • constipation _
  • feeling of incomplete defecation,
  • difficulty getting pregnant
  • complications of pregnancy (miscarriage, abnormal position of the fetus).

Fibroids can grow up to 20-30 cm in diameter and compress nearby organs and nerves, resulting in difficulties with urination and constipation. They can also compress the large intestine, leading to constipation or pressure on the stool.

Uterine fibroids rupturing

The fibroid may rupture in extremely rare cases. This can occur as a result of a sprained fibroid, increased abdominal pressure, or an injury. A ruptured fibroid may cause the following symptoms:

  • severe abdominal pain,
  • increase in body temperature,
  • cold sweats
  • tachycardia
  • vaginal bleeding.

Although extremely rare, uterine fibroid rupture is a serious condition that requires urgent medical attention.

Uterine fibroids and bleeding

Abnormal bleeding is a common symptom of fibroids, often goes unnoticed. It can be more heavy or prolonged periods, or a different point in the cycle. Blood loss associated with fibroids can lead to anemia, so it is important to report it to the gynecologist.

How to treat uterine fibroids

Asymptomatic fibroids do not need to be treated. If the fibroid is asymptomatic but you monitor its growth at the doctor’s office and it has grown by about 1 cm in a year, there is no need to wait until it becomes massive or causes anemia.

Treatment of uterine fibroids includes:

  • Pharmacological treatment  
  • Non-surgical procedures 
  • Operative treatment 

Surgical methods, medications, and ultrasound beams are used to treat fibroids, but certain conditions must be met to qualify for the removal of fibroids by ultrasound.

  • fibroids should be in the anterior wall or fundus of the uterus,
  • number of fibroids: up to 3,
  • diameter of fibroids: 3-7 cm,
  • abdominal fat thickness < 2 cm.

What to avoid with fibroids?

If you have uterine fibroids, try to avoid:

  • red meat,
  • highly processed food,
  • sugar,
  • sweet drinks,
  • sweets,
  • animal fats,
  • caffeine,
  • alcohol.

Consequences of untreated uterine fibroids

Uterine fibroids are usually harmless, but if left untreated, they can cause anemia due to iron loss. As a result, a woman may experience weakness, fatigue, and dizziness. Other consequences of untreated fibroids concern pregnancy. Complications such as infertility or pregnancy loss, as well as placental abruption, premature birth, or slow fetal growth, may occur.

Is uterine fibroid cancer?

Uterine myoma is not cancer; it is not malignant, and it does not spread. Uterine fibroids are noncancerous tumors. They are benign tumors composed of smooth muscle cells from the uterus or smooth muscle cells surrounding the uterus. A fibroid, on the other hand, can become malignant in extremely rare cases.

Uterine fibroids and pregnancy

Fibroids can cause difficulties in getting pregnant, preventing fertilization or implantation of a fertilized egg, hindering the proper positioning of the fetus, and even leading to miscarriages. One of the most disturbing symptoms is the rapid enlargement of the fibroid, which needs to be examined thoroughly.

Uterine fibroids and physical effort

Regular moderate exercise can prevent uterine fibroids by controlling hormone levels and weight, but be careful with intense exercise and overloading the body. Recommended exercises are yoga and aerobic exercise.

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