Periods During Menopause

Menopause is the cessation of menstruation, commonly known as a “period,” and clinicians define menopause as going a full year without a period. The average age of menopause in the United States is about 50 years of age, with the normal range being 40 to 60 years of age. Any type of vaginal bleeding after menopause is cause for medical attention. Post-menopausal bleeding has a variety of possible causes, ranging from completely harmless to life threatening.

Hormones

The most common cause of post-menopausal bleeding is thinning of the lining of the uterus, which can result in some spotting. This typically occurs when a woman’s estrogen level drops after menopause. This condition can be treated with estrogen supplements administered vaginally, although treatment is not usually required.

Some medications such as hormone therapy and blood thinners can also cause periods after menopause. Hormone therapy can be categorized into cyclic regimens and continuous regimens. A cyclic regimen typically consists of a relatively large dosage of oral estrogen and progestin for at least 10 consecutive days during each month. This regimen routinely causes vaginal bleeding that resembles a regular period each month. This type of postmenopausal bleeding is expected and is not generally cause for alarm.

Continuous hormone therapy consists of an oral supplement of estrogen and progestin each day, although in a much lower dosage than that used by a cyclic regimen. Continuous hormone therapy can cause irregular bleeding for the first six months of the therapy. It is not typically cause for medical attention unless the bleeding lasts longer than six months or becomes heavy.

Growths

Growths such as polyps and fibroids can also cause postmenopausal bleeding. Polyps are usually benign, but they should be removed since they can become cancerous in rare cases. Fibroids are benign growths that usually shrink after a woman’s estrogen level drops during menopause. They usually don’t require removal treatment unless they began growing, which can cause bleeding after menopause.

Endometrial Hyperplasia

Endometrial hyperplasia is an excessive growth of the uterine lining. It is more likely in women who had high estrogen levels while they were still menstruating. This includes women who began menstruating early or entered menopause late in life. Endometrial hyperplasia is also more likely in women who are obese, have never given birth or have polycystic ovarian syndrome.

Endometrial hyperplasia is a more serious cause of postmenopausal bleeding and should be treated as quickly as possible. This condition increases a woman’s risk of developing cancer of the uterine lining, known medically as endometrial cancer. Postmenopausal bleeding is caused by endometrial hyperplasia 10 percent of the time, and an additional 10 percent of these cases are caused by endometrial cancer. Endometrial hyperplasia may be treatable with medication or it may require surgery, depending on its severity. The best prognosis for endometrial hyperplasia occurs when it is detected early.

Examinations

All women near menopause should receive regular examinations from their gynecologist. This should include a pelvic exam and Pap smear, which examines the cervical cells for signs of cancer. They should also receive a breast exam and mammogram to detect breast cancer. Postmenopausal women should also receive additional tests for their cholesterol level to assess the risk of arteriosclerosis. A blood sugar test can determine a woman’s risk of diabetes. The reduction of estrogen levels after menopause can also increase the risk of osteoporosis, or porous bones.


 

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