Menopause is defined as cessation of menstruation after twelve months of amenorrhea. It is a stage where the natural capacity of reproduction in a woman comes to an end. Usually menopause sets in anywhere between 45 to 55 years in a woman. However, in some woman it may be few years early or late. Spotting after menopause or bleeding after menopause is not normal. The cause may be minor due to change in vagina, cervix or uterine lining or it can be more serious such as endometrial cancer. When detected early most causes of postmenopausal bleeding including endometrial carcinoma can be treated successfully.
Causes of Spotting After Menopause:
For many women menopause is a welcome relief from menses. But often when a woman experiences spotting or bleeding after menopause she gets confused and stressed. However, most of the underlying causes for postmenopausal bleeding are not concerning. But if the bleeding is frequent, it needs to be investigated as it may be a symptom of serious health problem such as endometrial or cervical malignancy. In majority of cases the cause of spotting after menopause is not found. But if the cause is malignancy, it can be detected with various investigative studies.Here are some important reasons for postmenopausal spotting:
- After menopause the estrogen level in the body drops. Estrogen is an important female hormone that regulates menses along with various other functions. Low level of estrogen after menopause thins out the lining of wall of vagina, uterus and cervix. In medical terminology this is referred as vaginal atrophy. Because of thinning, the wall lining become fragile and gets easily injured. It can cause sexual discomfort. Sometime spotting in such case occurs after intercourse.
- Spotting can also occur due to polyps in uterus or on cervix. Polyps are small tiny non malignant growths. Usually they shrivel after menopause. However, if present and produce bleeding they must be removed as there is risk of malignancy.
- Some women may have thickened endometrium due to hormone replacement therapy or due to overweight. Endometrial hyperplasia as it is known can also produce postmenopausal bleeding.
- Cancer of cervix or uterus can also give rise of postmenopausal bleeding.
What should you do for spotting after menopause?
- Spotting after menopause is not normal finding. The incidence of spotting or bleeding after menopause in general population can be at least 10% after menopause. Of them at least one percent is caused due to abnormality of endometrium, whether the cause is benign or malignant. Hence it is important to consult your doctor to rule out endometrial cancer if you experience bleeding anytime after menopause.
- The treatment of postmenopausal spotting may depend on the underlying cause. The health practitioner may physically examine vaginal area and the uterus for any abnormalities. He may examine the area with speculum and also remove tiny tissue sample for PAP smear to rule out cervical cancer. Sonography of pelvis is also recommended by the doctor.
- If the underlying cause is vaginal atrophy or thinning of uterine lining, treatment consists of certain drugs that contain estrogen. Tablets, gel, ointment containing estrogen is placed inside the vagina. At times doctors also prescribe vitamin E capsules to be inserted in the vagina or to be swallowed orally. Vitamin E improves the blood vessel condition of the atrophied vagina which resolves inflammation and bleeding.
- Omega 3 is useful for decreasing inflammation. Eat foods that are rich in omega3 such as flaxseeds, fish, almonds, walnuts etc. Staying sexually active also increases the blood circulation in vaginal region as well as it also prevents dryness. Vitamin E capsules can act as natural lubricant.
- Polyps need to be removed surgically and sent for histopathological test to rule out malignancy.
- If overweight and obesity are the underlying cause for endometrial hyperplasia, you have to reduce weight. In some cases hormone therapy may be effective. If the problem still persists, surgical removal of the thickened lining may be required.