{"id":17397,"date":"2020-05-18T15:47:41","date_gmt":"2020-05-18T13:47:41","guid":{"rendered":"https:\/\/www.intimina.com\/blog\/?p=17397"},"modified":"2020-09-29T13:09:45","modified_gmt":"2020-09-29T11:09:45","slug":"postmenopausal-bleeding","status":"publish","type":"post","link":"https:\/\/www.intimina.com\/blog\/postmenopausal-bleeding\/","title":{"rendered":"I thought I Was Done! Postmenopausal Bleeding"},"content":{"rendered":"<p style=\"font-size: 14px; font-weight: bold;\"><em>This article was medically fact-checked by <a href=\"#drscroll\">Consultant Obstetrician and Gynaecologist Dr. Shree Datta<\/a>.<\/em><\/p>\n<p><span style=\"font-weight: 400;\">Ah the beauty of menopause. Despite the backwards ideas we have around aging in many western societies, <\/span><a href=\"https:\/\/www.intimina.com\/blog\/menopause-benefits\/\"><span style=\"font-weight: 400;\">menopause<\/span><\/a><span style=\"font-weight: 400;\"> comes with a variety of gifts and is something to be celebrated. Much like menarche.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As always, the female body is full of twists, turns, and surprises. For some women, just when they think they\u2019ve finally passed the crimson tide for good &#8211; surprise! A random onset of bleeding, or spotting.\u00a0<\/span><\/p>\n<p><b>Out of Retirement<\/b><\/p>\n<p><span style=\"font-weight: 400;\">What gives? I thought my ovaries retired to a leisurely beachfront condo.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Post-menopausal bleeding could be caused by a variety of reasons. So let\u2019s take a look at just what the deal is when it comes to surprise bleeding.<\/span><\/p>\n<p><b>What\u2019s The Deal?<\/b><\/p>\n<p><span style=\"font-weight: 400;\">First and foremost, while post-menopausal bleeding is often not a problem, it is considered \u201cabnormal\u201d and a good reason to consult your doctor. Postmenopausal bleeding is any bleeding that occurs at least 12 months after a woman\u2019s last period.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">About 4-11% of postmenopausal women experience some sort of bleeding. For most people who do bleed after menopause, it occurs within the first year, and chances become less and less the longer someone has been in menopause.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Having said that, on average, people with endometrial cancer typically develop it in their 60\u2019s- when they\u2019ve most likely been out of period land for a few years.\u00a0<\/span><\/p>\n<p><b>That Cozy Layer in Your Uterus<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Endometrium is the cushy layer of blood and tissue that lines the insides of the uterus to make it hospitable for any potential life to grow. This is also what sheds during menstruation.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There\u2019s a potential for post-menopausal people with an excess of estrogen, and little progesterone to balance it out, to develop endometrial hyperplasia. This causes the endometrium to get thicker, which can cause heavy bleeding, and may develop into endometrial cancer.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As scary as the C-word can be, endometrial cancer is typically diagnosed early on and has an over <\/span><a href=\"https:\/\/www.cancer.org\/research\/cancer-facts-statistics\/all-cancer-facts-figures\/cancer-facts-figures-2012.html\"><span style=\"font-weight: 400;\">95% five-year survival rate<\/span><\/a><span style=\"font-weight: 400;\">. This is in part due to the more than 90% of patients who experience bleeding as an early symptom- an immediate red flag. Being the most common gynecological cancer, endometrial cancer affects an estimated <\/span><a href=\"https:\/\/www.health.harvard.edu\/womens-health\/postmenopausal-bleeding-dont-worry-but-do-call-your-doctor\"><span style=\"font-weight: 400;\">2-3% of women<\/span><\/a><span style=\"font-weight: 400;\"> in the U.S.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the U.S., endometrial cancer only affects about 3% to 7% of women who experience post-menopausal bleeding. Your doctor can help rule it out, or if present- determine a course of action and proper treatment plan.\u00a0<\/span><\/p>\n<p><b>There\u2019s a Lot Going On<\/b><\/p>\n<p><span style=\"font-weight: 400;\">There\u2019s a lot of equipment down there, and if you\u2019re not expecting it- it may be hard to determine just where the bleeding is coming from. Postmenopausal bleeding could potentially come from the vagina, the cervix, the vulva, urethra, fallopian tubes, even the anus. Not to undermine people\u2019s awareness of their own bodies, but it is something to be aware of.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Depending on the nature of the bleeding, and other symptoms that accompany it, your doctor may utilize a variety of tests to check things out. A transvaginal ultrasound, endometrial biopsy, MRI scan, <\/span><a href=\"https:\/\/www.winchesterhospital.org\/health-library\/article?id=101076\"><span style=\"font-weight: 400;\">hysteroscopy<\/span><\/a><span style=\"font-weight: 400;\">, as well as sonography are all tools used by gynecological oncologists to determine the cause of postmenopausal bleeding. In the case of PMB, it\u2019s especially important to maintain an up to date pap smear.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These tests can help to determine any fibroids and tumors that may be happening in the lower reproductive organs, and whether or not they are benign.\u00a0<\/span><\/p>\n<p><b>Medications and Menopause<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Another potential cause of bleeding? Hormone replacement therapy, or HRT. <\/span><a href=\"https:\/\/www.cdc.gov\/nchs\/data\/nhanes\/databriefs\/hrtinwomen.pdf\"><span style=\"font-weight: 400;\">About <\/span><\/a><span style=\"font-weight: 400;\">44% of post-menopausal women have used HRT, with bleeding being a potential side effect. It is also a side effect of other medications like blood thinners and estrogen modulators.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In <\/span><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3603898\/\">rare cases<\/a>,<\/span><span style=\"font-weight: 400;\"> postmenopausal bleeding can occur from Corticosteroid injections- a fairly common treatment to relieve chronic pain.\u00a0<\/span><\/p>\n<p><b>Lube It Up<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Much like the rest of the body, the tissues of the vagina can thin and become more susceptible to breakage with age. This coupled with a decrease in vaginal dryness, may lead to abbrasions during sex or vaginal penetration, which could cause mild bleeding. If this is the case, it\u2019s a good time to call up your old pal lube.<\/span><\/p>\n<p><b>What\u2019s up Doc?<\/b><\/p>\n<p><span id=\"drscroll\" style=\"font-weight: 400;\">While post-menopausal bleeding can be caused by Hormone Replacement Therapy or one last burst of a period, it&#8217;s important to investigate it ASAP, to rule out something more serious.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another reminder- here at Intimina, we\u2019re not gynecologists, and we can\u2019t offer you a diagnosis. So if you\u2019re experiencing post-menopausal bleeding, this is something to take up with your doctor.<\/span><\/p>\n<div class=\"drstamp\" style=\"margin-bottom: 10px; background-color: #fff5f7; padding: 20px 20px 5px 20px;\">\n<h3 style=\"padding-bottom: 10px;\">Facts checked by:<\/h3>\n<h3 style=\"color: #ed008c;\"><strong>Dr. Shree Datta<\/strong><\/h3>\n<p><img decoding=\"async\" class=\"alignleft wp-image-28100\" style=\"padding-top: 5px;\" src=\"https:\/\/www.intimina.com\/blog\/wp-content\/uploads\/2020\/05\/3LQ6bY-L_400x400.jpg\" alt=\"Dr. Laurie Mintz, Ph.D.\" width=\"110\" height=\"96\" \/><\/p>\n<p style=\"font-size: 14px;\">Dr. Shree Datta is a Consultant Obstetrician and Gynaecologist in London, specialising in women&#8217;s health including all menstrual problems such as fibroids and endometriosis. Dr. Shree is a keen advocate for patient choice, having written numerous articles and books to promote patient and clinician information. Her vision resonates with INTIMINA, with the common goals of demystifying periods and delivering the best possible care to her patients<\/p>\n<p style=\"font-size: 14px;\"><strong><a href=\"https:\/\/www.themedicalchambers.com\/find-a-clinician\/ms-shree-datta\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Medical<\/a><\/strong> | <strong><a href=\"https:\/\/uk.linkedin.com\/in\/shree-datta-10320327\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">LinkedIn<\/a><\/strong> | <strong><a href=\"https:\/\/twitter.com\/drshreedatta\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Twitter<\/a><\/strong><\/p>\n<\/div>\n<h3 style=\"padding-left: 20px;\">Written by:<\/h3>\n","protected":false},"excerpt":{"rendered":"<p>This article was medically fact-checked by Consultant Obstetrician and Gynaecologist Dr. Shree Datta. Ah the beauty of menopause. Despite the backwards ideas we have around aging in many western societies,&hellip;<\/p>\n","protected":false},"author":24,"featured_media":17398,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false},"categories":[12],"tags":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.12 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What is Postmenopausal Bleeding - Where does it come from?<\/title>\n<meta name=\"description\" content=\"Pmenopausal bleeding is often not a problem, it is considered \u201cabnormal\u201d and a good reason to consult your doctor.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.intimina.com\/blog\/postmenopausal-bleeding\/\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Natasha Weiss\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.intimina.com\/blog\/postmenopausal-bleeding\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.intimina.com\/blog\/postmenopausal-bleeding\/\"},\"author\":{\"name\":\"Natasha Weiss\",\"@id\":\"https:\/\/www.intimina.com\/blog\/#\/schema\/person\/b6c60ecf47ec06a36c4b2f175253c5ff\"},\"headline\":\"I thought I Was Done! 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