Vaginal Bleeding After Menopause: 9 Things That Can Cause It, And When To Be Concerned


Vaginal Bleeding After Menopause: 9 Things That Can Cause It, And When To Be Concerned

If a woman has gone through menopause (that is, haven’t had a period in at least 12 months), she is not expected to have vaginal bleedings anymore. But if you’re postmenopausal and experience bleeding from the vagina, it’s imperative that you tell your gynecologist about this symptom.

In some cases, a woman ceases to have periods and assumes she is menopausal. And then, much to her surprise, monthly bleedings resume. This means that the menopause isn’t really over. But in women who are actually postmenopausal, there is a number of causes of vaginal bleeding, some of which are not dangerous and relatively easy to treat. More serious causes include cancers of the reproductive organs.

In any case, if you have any vaginal bleedings that aren’t periods, you should schedule an appointment with your doctor.

Causes of postmenopausal bleeding

Postmenopausal bleeding may be caused by the following:

Vaginal atrophy

Decreased production of estrogen can lead to thinning of vaginal tissue, dryness, and inflammation. This can lead to discomfort and bleeding, especially after intercourse.


Polyps are benign growths that can develop in the uterus, cervical canal, or on the cervix. Vaginal bleeding may be the only symptom that they cause. In most cases, polyps are benign, but they may have the potential to become cancerous.

Endometrial atrophy

Due to the lack of sex hormones, endometrium (lining of the uterus) can become thin, which can lead to bleeding.

Endometrial hyperplasia

This can be considered the opposite of endometrial atrophy. In endometrial hyperplasia, excess estrogen and lack of progesterone can cause the uterine lining to become thick, which may lead to bleeding. Endometrial hyperplasia can increase the risk of endometrial cancer if left untreated.


Cancers of the uterus, cervix, and vagina all can cause postmenopausal bleeding.

Other causes of postmenopausal bleeding include the following:

  • endometritis (infection of the uterine lining);
  • being on hormone therapy;
  • use of certain drugs, such as blood thinners;
  • sexually transmitted diseases, including gonorrhea and chlamydia.

Treatment of postmenopausal bleeding

Treatment of postmenopausal vaginal bleeding depends on the cause and may involve the following:

  • estrogen therapy for vaginal or endometrial atrophy;
  • progestin therapy for endometrial hyperplasia;
  • hysteroscopy and D&C (dilation and curettage) to remove polyps or thickened areas of the uterine lining caused by endometrial hyperplasia;
  • for cancer, surgical removal of a part or the whole affected organ;
  • radiation and chemotherapy for cancer;
  • hormone therapy to prevent cancer recurrence.

As you can see, some causes of postmenopausal bleeding are quite serious, which is a good reason to see a doctor if such symptom is present. You should also have annual (or more frequent) gynecological exams to detect a problem early if it develops.

This article is purely for informational purposes. Do not self-medicate, and in all cases consult a certified healthcare professional before using any information presented in the article. The editorial board does not guarantee any results and does not bear any responsibility for harm that may result from using the information stated in the article.

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