Post-Menopausal Bleeding Not Normal

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By Jeanie Lerche Davis
WebMD Feature

Reviewed By Charlotte Grayson

If you're past menopause and haven't had a period for several months -- then start having minor bleeding once a month or so -- you should probably see a doctor.

"Abnormal bleeding in a woman is always cause for concern," says Lila E. Nachtigall, MD, a reproductive endocrinologist and director of the Women's Wellness program at New York University School of Medicine in New York City.

When a woman is in perimenopause -- usually during her 40s -- it's normal to skip one period and have one the next month, she tells WebMD.

"But if a woman didn't have a menses for nine months and then she bled, [a doctor] would always evaluate that," Nachtigall says. A pelvic exam, [ultrasound], and possibly a biopsy might be necessary to determine if it is endometrial [uterine] cancer or pre-endometrial cancer, called hyperplasia.

"We're always suspect," she adds. "It's not always cancerous. Sometimes abnormal bleeding does occur. But you really have to watch it; it should be investigated. We're lucky with uterine cancer in that there's always bleeding and therefore we can catch it early [when it is almost always treatable]."

Post menopausal bleeding can originate from other problems such as:

• Hormone replacement therapy
• Uterine (endometrial) polyps
• Cervical Cancer
• Cuts or lesions on the outside of the vagina
• Sex

Originally published Oct. 7, 2002

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