Bleeding after menopause: It’s not normal

Postmenopausal bleeding is never normal and may in fact be an early symptom of endometrial cancer, says UT Southwestern gynecologic cancer specialist Matthew Carlson, M.D.

“Too often I see women with advanced endometrial cancer [uterine cancer] who tell me they experienced postmenopausal bleeding for years but didn’t think anything of it,” Dr. Carlson says.

A woman is considered to be in menopause after 12 consecutive months without a menstrual cycle. She may experience irregular bleeding leading up to menopause, a stage known as perimenopause. But once she’s in menopause, all vaginal bleeding should stop.

There are benign causes of postmenopausal bleeding. For about 10 percent of women, however, the cause is endometrial cancer. 

Early diagnosis offers the best chance to beat endometrial cancer. Dr. Carlson urges women to treat postmenopausal bleeding as cancer until proven to be something else and see a gynecologist immediately. Acting quickly reduces potential complications, simplifies care, and improves chances of survival should the cause of the bleeding turn out to be cancer.

He also encourages women to continue seeing their gynecologist regularly after menopause. Cancer risk increases with age, and a gynecologist can screen for the disease and help manage any conditions caused by hormone changes.

Women often focus on their families first and put their own health second. But Dr. Carlson urges women to listen to their bodies and alert their doctor to any changes as soon as possible. As Dr. Carlson notes, “You can’t care for your loved ones if you’re not healthy yourself.”

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