Spotting After Menopause -
What Can Cause It?
Menopause - Symptoms - Nutritional - Supplements - Information - Womens Health - Natural Products
Spotting after menopause, of course, refers to spotting or
bleeding by a woman who is in post menopause.
As women approach menopause the menstrual bleeding
pattern changes with periods usually becoming lighter and shorter in
duration. So that once you are in menopause and post menopause there
is no more bleeding. However, there can be unexpected post menopause
spotting and bleeding. For the most part this after menopause
spotting and/or bleeding can be caused by something benign such as
an infection or a tear of the uterine or vaginal lining. The decline of estrogen levels in menopause cause
the vaginal mucosa to become thinner and dryer and less elastic and
predisposed to bleed. Sometimes this lining can be broken or easily
inflamed and bleed. It can also become injured during intercourse or
even during a pelvic exam.
One of the most common causes of bleeding
orspotting after menopause is synthetic hormone replacement therapy,
especially estrogen replacement therapy.
Women who are on HRT may often develop post
menopause spotting because the uterine lining is very sensitive to
estrogen, which promotes the growth of the endometrium; the uterine
lining that builds up and is discharged during a normal menstrual
cycle. Hence bleeding and spotting so this lining can be
released. On the other hand, lack of estrogen may cause the atrophy
of the uterine lining in which case the blood vessels of the uterine
lining become so fragile as a result of lack of estrogen that they
spontaneously break and then bleed causing spotting. Some other causes of spotting after menopause are
the development of polyps and fibroids. These are benign growths
that develop in the uterine cavity. Polyps are most often associated with irregular
light spotting, staining or light bleeding. Fibroids may also
produce the same light symptoms but are also associated with much
heavier bleeding. Overgrowths of lining of the uterus called
hyperplasias may also be the cause of abnormal post menopausal
spotting and bleeding. This condition can have some malignant potential.
About 20% of women who have this type of post menopausal bleeding
may have cancer of the endometrium, the uterine lining.
What To Watch For In Menopausal Spotting
If you have any unusual or unexplained menopausal
spotting or bleeding or post menopausal bleeding, you should consult
your doctor. Endometrial hyperplasia, the abnormal thickening of
the uterine wall may indicate a pre-cancerous condition. Endometrial
cancer is the highest incidence of cancer in post menopausal women.
However, abnormal bleeding from uterine cancer
occurs early in the disease when it is highly curable. Some of the early signs of uterine cancer are:
- Post menopausal spotting or bleeding, especially after
intercourse. This occurs after there has been no menstruation for
12 months. A watery or blood-streaked vaginal discharge may
precede spotting or bleeding.
Cramps in the lower abdomen
Enlarged uterus
- In later stages the cancer may have spread to other organs
causing abdominal pain, chest pain and weight loss
Some of the options your gynecologist may use in
evaluating after menopause spotting that concerns you are:
- A D&C, dilating your cervix and scraping the lining of the
uterus
A hysteroscopy, looking inside your uterus with a small
viewing device inserted through the cervix
An endometrial biopsy, taking a small sample in the office
without having to dilate the cervix
- An ultrasound to measure the thickness of the uterine lining
Recent studies suggest that if the uterine lining is
very thin, the chance of uterine cancer is lower. If you are having symptoms of after menopause
spotting and you are concerned about being at risk for more serious
complications, then make sure you see your doctor for regular pelvic
examinations and Pap smears every six to twelve months.
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