Heavy Bleeding After Menopause: Causes and Treatments


Heavy Bleeding After Menopause: Causes & Treatments

Menopause is a natural decline in reproductive hormones in females. It occurs when a female reaches her 40s or 50s. Menopause marks the end of fertility in females. Usually, a female doesn’t experience bleeding after menopause.

Several health complications can cause bleeding after menopause. Ignoring the symptoms or delaying the treatment can lead to severe health issues. Therefore, it’s extremely important to consult an experienced gynecologist on time so that it can be treated as well as possible complications can be avoided.

What Are The Causes of Heavy Bleeding After Menopause?

Several factors cause heavy bleeding after menopause. Some of the most common causes include the following.

  1. Vaginal dryness- Most women experience vaginal dryness after menopause due to significant drop in the estrogen level in the body. Estrogen is responsible for keeping the vaginal walls lubricated and supple. So,  excessive dryness of vagina can result in bleeding even upon slightest friction (even during sexual intercourse).  
  • Endometrial Atrophy

This is considered one of the most common causes of bleeding after menopause. The endometrial lining of a female may start becoming thinner if the production of estrogen stops after menopause. And as a result, the lining of the uterus may bleed. Endometrial atrophy can be termed as postmenopausal endometrial atrophy if it occurs after menopause.

  • Endometrial Hyperplasia

This is a medical condition of the female reproductive system. In the case of this disease, the lining of the uterus (endometrium) becomes thick due to having too many cells (hyperplasia). This causes heavy or irregular bleeding. 

The main cause of endometrial hyperplasia is excessive estrogen levels without progesterone to offset them. Endometrial hyperplasia is not cancerous but in rare cases, it may increase the chances of developing endometrial cancer that is a type of uterine cancer.

  • Endometrial Cancer

Endometrial cancer is also called uterine cancer. Endometrial cancer is a type of cancer that occurs in the lining (endometrium) of the uterus. Research suggests that around 10% of postmenopausal females experience bleeding due to endometrial cancer.

  • Uterine Polyps

This is a non-cancerous growth attached to the inner wall of the uterus that causes unusual or heavy bleeding. This condition is very common in females who are undergoing menopause or have completed menopause. The size of polyps varies and sometimes they can grow inside the cervical canal. In this case, a female may experience bleeding during sexual intercourse.

Apart from all the above-mentioned, certain complications may also cause heavy bleeding after menopause. This may include the following.

  • Clotting problems
  • Trauma to the pelvis
  • Thyroids disorders
  • Bleeding from the urinary tract
  • Endometritis or infection of the uterine lining

No matter what causes postmenopausal bleeding, if a female is suffering this problem, she needs to contact an experienced gynecologist and discuss the problem. Based on her symptoms, the gynecologist recommends certain tests and then decides the treatment method for the same.

What Are The Treatments For Heavy Bleeding After Menopause?

The treatment of postmenopausal bleeding largely depends on its causes. Following are the treatment options that a gynecologist may recommend to treat bleeding after menopause.

  • Medications For Postmenopausal Bleeding

Several medications are there that can be used to treat postmenopausal bleeding. The gynecologist may prescribe antibiotics for sexually transmitted diseases. However, based on the causes of bleeding and its severity, the gynecologist may change the prescription as well.

  • Estrogen Therapy For Postmenopausal Bleeding

The gynecologist may use estrogen therapy to treat vaginal and endometrial atrophy. This can be prescribed in the form of pills, vaginal cream, vaginal ring, or vaginal tablet.

  • Progestin Therapy For Postmenopausal Bleeding

This is a lab-made version of progesterone that is used to treat endometrial hyperplasia. The gynecologist may prescribe it in the form of pills, shots, vaginal cream, or an intrauterine device.

  • Hysteroscopy For Postmenopausal Bleeding

During this procedure, the gynecologist inserts a hysteroscope into the vagina and passes a tiny surgical instrument through the tube. After that, the gynecologist removes polyps as well as the thickened parts of the uterine lining caused by endometrial hyperplasia.

  • Dilation & Curettage (D&C) For Postmenopausal Bleeding

During this surgery, the gynecologist uses a thin tool to remove the polyps or thickened parts of the uterine lining caused by endometrial hyperplasia.

  • Hysterectomy For Postmenopausal Bleeding

This is a surgical procedure during which a gynecologist removes a part of or the complete uterus. Hysterectomy is considered the best treatment for endometrial or cervical cancer. Hysterectomy can also be used to treat people with a precancerous form of endometrial hyperplasia.

Not only this, but the gynecologist may also remove ovaries, fallopian tubes, or nearby lymph nodes in some cases. In case of cancer, the gynecologist may also suggest radiation, chemotherapy, or hormone therapy.


Research suggests that around 4-11 percent of women experience vaginal bleeding after they go through menopause. Females can experience bleeding before they go through menopause, known as perimenopause bleeding. However, bleeding after menopause is not normal. If a woman experiences postmenopausal bleeding, seeing a gynecologist is extremely important. Because the gynecologist can rule out the actual causes of bleeding and offer the most-suitable treatment on time.


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