Post-Menopausal Bleeding

Ah, Menopause And All It Brings Along

Menopause is that time in a woman's life when her body determines it is ready to stop the reproductive process and head off into other adventures. It usually begins around the late 40s and stretches through to the mid to late 50s. However, some women begin menopause very early and others are thrown into a premature menopause when they have a hysterectomy (removal of the reproductive organs.)

Of course, there are all sorts of signs that go along with menopause, hints that the body is changing. Night sweats, hot flashes, mood swings, insomnia, and weight gain, are some of the more familiar items that accompany "the change of life." Vaginal dryness is also common, and for some women, the resumption of vaginal bleeding after about six months of absence, is yet another experience. Most women approaching menopause have lighter periods that are shorter in duration, with intervals either closer together or farther apart than her regular period was when she was menstruating normally. The time between "periods" becomes greater until, after one year of missed periods, a woman is menopausal.

Post-Menopausal Bleeding And HRT

Post-menopausal bleeding, resumption of bleeding six months after cessation, can be caused from a number of things. The most common is hormone replacement therapy (HRT.) HRT replaces estrogen, which is the hormone that causes the uterine lining to thicken in preparation for a fertilized egg, just as it did during the normal reproductive cycle prior to menopause. The uterine lining is very sensitive to estrogen and may begin bleeding when the supplies are increased through HRT. Conversely, if there is a lack of estrogen, then the blood vessels of the uterine lining become very fragile as the endometrium atrophies. Because of the lack of estrogen, the blood vessels break and bleed.

Other Causes Of Post-Menopausal Bleeding

Other causes of post-menopausal bleeding may be polyps or fibroids, which are commonly found developing in the uterine cavity. They are usually benign growths. Polyps are often the cause of irregular light spotting, staining, or light bleeding. Fibroids may cause all of the same symptoms as polyps, but the bleeding tends to be heavier.

The "C" Word

Hyperplasia also can be a potential cause of post-menopausal bleeding. These overgrowths of the endometrium, or uterine lining, have the potential to become malignant and do so in about 20% of cases of post-menopausal bleeding.

If a woman experiences post-menopausal bleeding, she should visit her health care provider for a thorough examination. The bleeding may be a minor issue, or it may be the indication of something major. Whether it is a hormonal imbalance due to HRT, benign growths, or fibroids, treatment is important. In many cases where cancerous cells are found, treatment is often successful in controlling the disease, emphasizing the fact that post-menopausal bleeding be checked and taken seriously.