Understanding postmenopausal bleeding: Causes and when to seek help

Postmenopausal bleeding (PMB) refers to vaginal bleeding occurring after a woman has experienced 12 consecutive months without a menstrual period, marking the onset of menopause. While PMB can be alarming, it is not always a cause for concern. Understanding its potential causes and when to seek medical attention is essential for maintaining long-term health.

Causes

The most common cause of PMB is atrophic vaginitis or endometrial atrophy, both of which result from the natural thinning of vaginal and uterine tissues due to decreased estrogen levels. Another frequent cause is hormone replacement therapy (HRT), which can sometimes disrupt the delicate hormonal balance, leading to irregular bleeding. Less commonly, PMB can result from uterine polyps or fibroids, which are typically benign growths but may cause irregular spotting or bleeding.

However, postmenopausal bleeding should never be ignored, as it can sometimes indicate more serious conditions. In about 10% of cases, PMB is linked to endometrial cancer, the most common type of gynecological cancer. Early detection is critical, as treatment is often more effective in the initial stages. Other potential causes include cervical or vaginal cancers, pelvic infections, or conditions like adenomyosis. If you experience postmenopausal bleeding, it is essential to consult a healthcare professional promptly.

Diagnosis

Diagnostic steps may include a physical examination, a transvaginal ultrasound to assess the uterine lining, or an endometrial biopsy to check for abnormal cells. Additional imaging tests or procedures like hysteroscopy may be recommended for a more detailed evaluation. Timely medical intervention not only ensures accurate diagnosis but also provides peace of mind. For many women, PMB is caused by treatable or benign conditions.

However, addressing the issue promptly helps rule out or address more serious concerns, ensuring better health outcomes. By staying vigilant and seeking help when needed, women can take proactive steps to manage their health and well-being during the postmenopausal years.