What to do about postmenopausal bleeding

Menopause is another transition period in a woman’s life, just like puberty. It means having one full year of no periods. And any type of bleeding or spotting beyond that is not considered normal.

Is it normal?

Postmenopausal bleeding may be a sign of a minor health problem, but can also be an early sign of something more serious in some cases. When given medical attention right away, most conditions causing the postmenopausal bleeding can be successfully treated.

What are the causes?

Bleeding after menopause is rarely cause for concern. It must, however, be consulted with a doctor immediately to find out what’s causing the bleeding. In most cases, postmenopausal bleeding is caused by:

  • Atrophic vaginitis: inflammation and thinning of the lining of your vagina
  • Polyps: growths in the cervix or uterus which are usually not cancerous
  • Endometrial hyperplasia: thickened endometrium (often because of hormone replacement therapy that decrease some menopausal symptoms)
  • Abnormalities in the cervix or uterus.
  • Cervicitis or endometritis: infection or inflammation in the cervix or uterus
  • Uterine cancer or endometrial cancer
  • Cervical cancer

What should I do?

It’s best to consult a doctor right away when any kind of bleeding or spotting occurs after menopause. The doctor will perform a physical exam and will review the patient’s medical history. Other tests may also be required, such as a transvaginal ultrasound, endometrial biopsy, sonohysterography, hysteroscopy, or dilation and curettage. 

How is it treated?

The right treatment for postmenopausal bleeding will depend on what’s causing it. Medication and surgery are the most common treatments.

Medications may include antibiotics, estrogen therapy, or progestin therapy. Meanwhile, possible surgical procedures may be hysteroscopy, dilation and curettage, or hysterectomy.


Cleveland Clinic Medical Professional. (May 26, 2021). Postmenopausal Bleeding. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/21549-postmenopausal-bleeding 

Johnson, T. (January 25, 2022). Postmenopausal Bleeding. WebMD. https://www.webmd.com/menopause/postmenopausal-bleeding 

Casper, K. (June 29, 2023). Should you be concerned about postmenopausal bleeding? Mayo Clinic Health System.


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