Sometimes vaginal bleeding during menopause is normal. hormone replacement therapy and birth control pills that include both estrogen and progesterone each restore your body’s hormonal balance. Most treatment regimens deliver these hormones in a cycle that emulates your body’s natural hormonal cycle. As a result, some women experience period like bleeding each month. Such bleeding is predictable and moderate, and may eventually go away as your body’s natural hormone levels continue to change. This bleeding, called dysfunctional uterine bleeding (dysfunctional uterine bleeding), is most likely to disappear altogether when hormone replacement therapy is continuous (see, “What Is Hormone Replacement Therapy (hormone replacement therapy)?” for more information). Often your doctor can eliminate dysfunctional uterine bleeding by starting you on hormone replacement therapy or by modifying your hormone replacement therapy regimen.
Sometimes bleeding is heavy or wildly irregular, or starts again after months or years without bleeding. In these circumstances, have your doctor check you out. Although serious health problems such as cancer are relatively rare, their likelihood increases with age. Abnormal uterine bleeding (abnormal uterine bleeding) generally has a clinical reason. Perhaps there are uterine fibroids or other medical conditions. Because abnormal uterine bleeding can indicate a precancerous condition or cancer itself, medical evaluation and treatment is essential.
Could It Be Cancer?
Vaginal bleeding can be a worrisome sign. Even though women bleed every month with their menstrual periods, bleeding is still an event that we tend to associate more with problems than with normal processes. This is particularly true when you think that your periods have stopped, and then all of a sudden you’re bleeding again. It’s natural to worry, because unexpected vaginal bleeding can be a sign of a serious health condition such as cancer, and that’s a good reason to have your doctor check you over.
A polyp is an abnormal growth that usually forms in mucous membrane tissue such as the cervix. A fibroid is a growth of muscle and connective tissue that forms in the uterus.
But most of the time, this bleeding is not serious. Other growths in the uterus, such as polyps and fibroids, can cause bleeding. Doctors often recommend surgery to remove these growths, which can have the potential to become cancerous.
Because cancer is always a possibility, you should notify your doctor about any unusual or unexpected bleeding. Doctors consider vaginal bleeding abnormal under these circumstances:
- It saturates more than one pad or tampon an hour for more than eight hours.
- Pain accompanies the bleeding.
- Bleeding starts for no apparent reason or doesn’t seem cyclical.
- It has been several to many years since you
- passed menopause (had your last menstrual period).
More than 14,000 women are diagnosed with invasive cervical cancer each year, and nearly 5,000 women will die from it. The good news is that doctors now know what causes nearly all cervical cancer: a virus called human papillomavirus (HPV). This virus shows up in 60 or so variations, several of which are linked to cervical and vaginal cancers; one variation causes genital warts. HPV can lurk in the body for years without causing any symptoms, and then emerge as cancer. Regular Pap tests and pelvic exams are an easy way to detect changes in cervical cells at an early stage, improving the odds that treatment will cure the cancer.
Narrowing the Possibilities
The first step in determining whether bleeding is abnormal or dysfunctional is a physical exam, including a careful history. Expect your doctor to do a thorough pelvic exam and Pap smear, and to ask questions about your menstrual pattern through your reproductive years, your sexual activity, and the history of your current symptoms. It’s important for your responses to be as specific as possible. This helps to zero in on the underlying cause of the bleeding. Depending on the initial findings, your doctor might want further tests. These might include blood tests, an ultrasound, or a hysteroscopy.
A hysteroscopy is a procedure during which the doctor passes a lighted magnifying scope through the vagina and cervix into the uterus to look for abnormalities. Hysteroscopy can often be done in the doctor’s office.
Choosing Appropriate Treatments
Of course, treatment depends on the diagnosis. Although cancer is relatively uncommon compared to the range of diagnostic findings, it generally requires immediate treatment to remove the cancerous tissue. This might include laser surgery or cryosurgery to superheat or superfreeze the cancerous cells, or hysterectomy. More advanced cancers require a more aggressive approach that includes some combination of surgery, radiation therapy, and chemotherapy.
The majority of unusual bleeding is dysfunctional uterine bleeding (dysfunctional uterine bleeding). Your body is experiencing a kind of withdrawal from estrogen and progesterone as your levels of these hormones drop. Medical interventions such as hormone replacement therapy or birth control pills often help, although these are not necessary if your doctor has eliminated any underlying problems and you’re willing to put up with the bleeding for what is usually no longer than a year or two. For most women who experience it, dysfunctional uterine bleeding goes away at the completion of menopause.
Iron deficiency anemia is a health condition in which the blood’s red cells are low in hemoglobin, reducing their ability to carry oxygen.
Living with Dysfunctional Uterine Bleeding
As a manifestation of menopause, dysfunctional uterine bleeding can certainly be frustratingly inconvenient. Although the bleeding is typically light, its irregularity makes it difficult for you to be prepared. Many women find some relief through herbal and natural menopause remedies that boost estrogen levels, such as dong quai and black cohosh. Regular exercise and a nutritional diet also help your body regain its rhythm. Some women worry about iron deficiency anemia resulting from the bleeding. This is something that your doctor will monitor through blood tests, but anemia isn’t as common during menopause as during the years of menstruation because blood loss is much less. Be sure to have your doctor check your blood hemoglobin level before you take an iron supplement. Too much iron is a serious health problem, and it doesn’t take much to get to that point.