Post-Menopausal Bleeding

Post-Menopausal Bleeding

WHEN TO SEE YOUR DOCTOR

* You have any bleeding at all after menopause—light or heavy.

* You are on hormone replacement therapy, and your bleeding is not on the cycle your doctor told you to expect.

What Your Symptom Is Telling You

Although menopause has come out of the closet in recent years, there are still plenty of women around who remember when it was oh-so-delicately referred to as the change of life. Today women heading through menopause might be likely to counter that with, "So what else is new? Change is life!"

One of the changes menopause will bring to your body is the end of your monthly menstrual period. This doesn't mean, however, that your period suddenly stops. It's very common for women going through menopause to have irregular cycles for a number of years, says Brian Walsh, M.D., assistant professor of obstetrics/gynecology and reproductive biology at Harvard Medical School and director of the Menopause Unit at Brigham and Women's Hospital in Boston.

Bleeding after menopause can have several causes. Lowered estrogen levels may cause thinning of the vaginal walls, which are then more likely to bleed, says Dr. Walsh. Growths in the uterus may cause bleeding, and some postmenopausal bleeding may even come from the bladder or rectum, he says.

You may be worried that your bleeding might be a sign of cancer. It's certainly possible, but uterine cancer has a dramatically high cure rate if detected early, says Dr. Walsh. Because this bleeding is such an early warning sign, an early cure is possible in 95 percent of cases.

Symptom Relief

Fortunately, there is a wide variety of treatments and cures for bleeding after menopause. Polyps or fibroids within the uterus can be removed with microsurgical techniques, infections can be treated with antibiotics and estrogen can help vaginal tissues to heal, Dr. Walsh says.

Keep a calendar. If you are taking hormone replacement therapy, you should still keep a record of your cycle and see your doctor every six months to a year, says Veronica Ravnikar, M.D., professor of obstetrics and gynecology and director of the Reproductive Endocrine and Infertility Unit at the University of Massachusetts Medical Center in Boston. "Be sure to ask your doctor what bleeding to expect," she says.

Plan on protection. If your regular Pap smears indicate dysplasia, you can help protect yourself from further exposure to the virus that may be responsible for it by shielding the cervix with a diaphragm or using a condom during intercourse. Dysplasia is increased activity in the cells of the cervix that can lead to cancer if untreated. It can be cured with cryosurgery and possible cervical excision, followed by careful monitoring using Pap smears.

Stub out that cigarette. Giving up smoking will also help keep your cervix healthy. Several studies have shown a relationship between cigarette smoking and cervical cancer.