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Bleeding After Menopause: Cause for Concern?

Q. What causes vaginal bleeding after menopause?

A. Between 4 and 11 percent of women will experience postmenopausal bleeding. The major concern associated with the condition is the possibility of endometrial cancer. It's most common in women who’ve recently experienced menopause; the risk of endometrial cancer continues to rise with age.

Endometrial cancer is found in about 10 percent of bleeding after menopause. Other types of cancer, such as ovarian cancer or cancer of the fallopian tubes, are less common but may also be associated with postmenopausal bleeding.

A woman experiencing postmenopausal bleeding should be evaluated by her gynecologist. Bleeding requires a careful examination of the genital tract structures. Endometrial cancer is typically ruled out with an endometrial biopsy and/or transvaginal ultrasound.

Two common causes of uterine bleeding are endometrial polyps and endometrial atrophy. Polyps are benign growths on the uterine wall, attached to the surface of the endometrium.

Endometrial atrophy occurs when the lining of the endometrium thins as a result of the menopausal drop in estrogen. A thinned endometrium lining is prone to irritation and bleeding. Other causes of bleeding after menopause include endometrial hyperplasia, in which the endometrium thickens as a result of excess estrogen; hormone therapy; and uterine fibroids.

Learn more about how to handle menopause symptoms, such as hot flashes and vaginal dryness.

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