What causes postmenopausal vaginal bleeding?

Renee E. Cotter, MD
OBGYN (Obstetrics & Gynecology)
Postmenopausal bleeding is always a concern, and should be evaluated even if it is a minor amount. Our first thought and worry is endometrial cancer, a cancer of the lining inside the uterus. The other causes could be cervical polyps, cervical cancer, it can even be that the lining in the uterus is too thin, also known as atrophic endometrium. If the woman is on hormone replacement, it can be related to hormone fluctuations or not taking the meds correctly, causing the woman to bleed.
Christina Goldstein-Charbonneau, DO
OBGYN (Obstetrics & Gynecology)
Vaginal bleeding after menopause is not normal and should be evaluated by your OB/GYN.  It may be benign, but it is imperative to exclude more serious causes. 
Such as:
1)  Uterine bleeding caused by fibroid, polyps, infection of the lining, hormone treatment, Tamoxifen,      endometrial cancer or precancerous cells or uterine sarcoma
2)  Cervical bleeding caused by inflammation, sexually transmitted diseases, trauma, cancer or precancerous    cells
3)  Ovarian cancer
4)  Vulvar cancer
5)  Vaginal causes such as vaginal dryness, atrophy (thinning of tissue), trauma, infection, bleeding disorder, or precancerous or cancer cells
A bloody vaginal discharge after menopause is commonly due to dryness and thinning of vaginal tissue from lack of estrogen. Vaginal infections such as yeast or bacterial vaginosis are another culprit.

Bleeding originating from the cervix can occur if there is a benign cervical polyp or cervical inflammation. Many sexually transmitted infections can cause cervical bleeding; if there is a new partner in your life, it is a good idea to be screened for chlamydia, gonorrhea and trichomonas. Cervical and vaginal cancers can also cause bleeding, but are less common.

Abnormal bleeding from the cavity of the uterus is caused by hormonal imbalances, benign growths such as polyps or fibroids, pre-cancer or cancer.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.