Starting from the late 30s, your ovaries tend to decrease production of female hormones bit by bit. When levels of estrogen and progesterone appear dramatically low, you will stop to ovulate and to menstruate at all.
If you miss periods during 12 months, this usually means that you've reached menopause.
The average American women go through menopause in 51-52 years old. But it may also occur in your 40s or after 55.
Once you're in menopause, any vaginal bleeding is recognized as abnormal condition, even if it is only spotting.
Postmenopausal bleeding is a common sign of endometrial, cervical and uterine cancers. That's why it's really important to visit your doctor, if experience any abnormal vaginal discharge.
However, there is a high number of other, non-cancerous reasons, why do women have bleeding after menopause. Here are the most frequent of them:
#1. Endometrial or vaginal atrophy - reduced production of reproductive hormones, particularly estrogen, impact on the uterine and vaginal lining, making them thinner. This can increase your risks of abnormal bleeding down there.
#2. Polyps – these benign formations may grow up in the uterine or cervix, causing irregular bleeding, which can be accompanied by pain during intercourses.
#3. Endometrial hyperplasia – though postmenopausal hormonal changes usually make uterine lining thinner, it can also become extremely thick, if your body contains too much estrogen without sufficient amount of progesterone. This may be a side effect of hormone replacement therapy. Endometrial hyperplasia may be a culprit of spotting or heavy vaginal bleeding. It was also found that this disorder can sometimes trigger development of endometrial malignancy.
#4. Trauma – vaginal bleeding after menopause may occur because of pelvic injury or assault.
#5. Infection – it usually leads to inflammation of the uterine lining (endometritis), which can manifest in bleeding (even if you've reached menopause), increased body temperature and pain.
Even if postmenopausal bleeding is light and doesn't cause any discomfort, you need to make an appointment with medical specialist, in order to identify underlying reason and treat it as soon as possible.
Your doctor will analyze you medical history, perform physical examination and do a Pap smear (screen test for cervical cancer).
You may also need transvaginal ultrasound, hysteroscopy, endometrial biopsy or/and sonohysterography. Some of these test may be done in the doctor's office, while others can be performed only in outpatient surgery center or hospital.
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