Vaginal Bleeding After Menopause

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is vaginal bleeding after menopause?

Vaginal bleeding after menopause refers to any vaginal or uterine bleeding that occurs after a woman has gone through menopause. Menopause is defined as having experienced a period of 12 consecutive months without a menstrual period.

All vaginal bleeding after menopause is abnormal and should be evaluated by a health care practitioner. Vaginal bleeding after menopause can result from gynecologic disorders, such as uterine prolapse, fibroids or polyps, or from complications of hormone replacement therapy (HRT). Remember, not all bleeding in the genital or vaginal area originates in the female genital tract. For example, hemorrhoids are often the unsuspected culprit.

The menstrual period is controlled by two hormones: estrogen and progesterone. After menopause, the production of these hormones declines substantially. Women who are on HRT may sometimes experience vaginal bleeding after menopause. Women with thyroid disorders may have hormonal imbalances that can result in vaginal bleeding after menopause.

Vaginal bleeding after menopause can occasionally be a sign of a serious or potentially life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, experience severe or uncontrolled bleeding accompanied by a fast heart rate. If you experience vaginal bleeding after menopause, seek prompt medical care. Your health care provider will determine the cause of your abnormal bleeding through a pelvic examination and other tests.

What other symptoms might occur with vaginal bleeding after menopause?

Vaginal bleeding after menopause may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Common symptoms that may occur along with vaginal bleeding after menopause

Vaginal bleeding after menopause may accompany other symptoms including:

Other symptoms that may occur along with vaginal bleeding after menopause

Vaginal bleeding after menopause may accompany symptoms related to other body systems including:

Symptoms that might indicate a serious condition

In some cases, vaginal bleeding after menopause may occur with other symptoms that might indicate a serious condition which should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have vaginal bleeding after menopause along with other serious symptoms including:

  • Rapid heart rate (tachycardia)
  • Severe or uncontrollable bleeding

What causes vaginal bleeding after menopause?

Vaginal bleeding after menopause refers to any vaginal or uterine bleeding that occurs after a woman has gone through menopause.

The menstrual period is controlled by two hormones: estrogen and progesterone. After menopause, the levels of these hormones decline significantly. Women who are on hormone replacement therapy may sometimes experience vaginal bleeding after menopause. Women with thyroid disorders or other conditions may have hormonal imbalances that can result in vaginal bleeding after menopause.

Gynecologic causes of vaginal bleeding after menopause

Vaginal bleeding after menopause may be caused by gynecologic disorders including:

  • Cyst (benign sac that contains fluid, air, or other materials)

  • Endometrial hyperplasia

  • Postcoital trauma

  • Sexually transmitted diseases

  • Uterine fibroids or noncancerous tumors of the uterus

  • Uterine polyps or masses in the endometrium

  • Uterine prolapse (irritated vaginal mucosa)

Hormonal causes of vaginal bleeding after menopause

Vaginal bleeding after menopause can also be caused by hormonal imbalances including:

  • Adrenal dysfunction

  • Changes in levels of estrogen or progesterone

  • Complications from hormone therapy

  • Hyperthyroidism (overactive thyroid)

  • Hypothyroidism (underactive thyroid)

Serious or life-threatening causes of vaginal bleeding after menopause

In some cases, vaginal bleeding after menopause can be a sign of a serious or potentially life-threatening condition. Examples include:

  • Cancers of the cervix, ovary, uterus or vagina

  • Trauma to the pelvis or abdomen

Questions for diagnosing the cause of vaginal bleeding after menopause

To diagnose your condition, your doctor or licensed health care provider will ask you several questions related to your vaginal bleeding after menopause including:

  • Have you gone through menopause?

  • When did you first notice the abnormal vaginal bleeding?

  • Do you have any other symptoms, such as fatigue or rapid heart rate?

  • What medications are you taking?

What are the potential complications of vaginal bleeding after menopause?

Because vaginal bleeding after menopause can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care provider design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment

  • Anemia (low red blood cell count)

  • Cancer of the uterus, ovary, bladder or other pelvic structures

  • Inability to participate normally in activities

  • Spread of cancer

  • Spread of infection

  • Transmission of STDs

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. Dysfunctional uterine bleeding (DUB). MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000903.htm.
  3. Lockwood CJ. Mechanisms of normal and abnormal endometrial bleeding. Menopause 2011; 18:408.
  4. APGO educational series on women's health issues. Clinical management of abnormal uterine bleeding. Association of Professors of Gynecology and Obstetrics, 2006.