Bleeding after menopause is treated in a variety of ways, depending on the root cause of the bleeding. Some types of vaginal bleeding that occur after a woman has been post-menstrual for some time are simply due to transient hormonal changes, and do not require any treatment at all. The most appropriate treatment, when it is required, for post-menopausal bleeding can usually only be determined after a full evaluation of the symptoms.
One of the commonest causes of menstrual bleeding after menopause is hormonal fluctuations. These may occur, for example, when a woman changes or stops hormone replacement therapy. The treatment for this type of bleeding after menopause usually consists of adjusting the hormonal therapy. Sometimes no treatment is needed, and the symptoms will eventually disappear naturally.
There are a number of common lifestyle issues that may cause bleeding after menopause, including stress, aggressive dieting, and poor diet. Treating these issues directly is often the best way to alleviate the bleeding. As such, post-menopausal women are often advised to avoid excessive stress, maintain a nutrient-rich diet, and to avoid rapid weight loss.
If a physician is concerned that the abnormal bleeding might have a more serious cause, then it may be necessary to perform an endometrial biopsy. The doctor passes a tool through the cervix and into the uterus, and then takes a sample of uterine cells. These cells are then analyzed in a laboratory to determine if an abnormality is present.
In a few cases, an endometrial biopsy will show that the bleeding after menopause is caused by an abnormality in the uterus, such as uterine hyperplasia, or even the more serious uterine cancer. Uterine hyperplasia is a non-cancerous condition where the cells of the uterine lining are growing more rapidly than normal. This can usually be treated non-invasively with hormonal drugs. In some cases, surgical treatment is needed, and in rare cases, this may even involve the removal of the uterus, a procedure known as a hysterectomy.
If uterine cancer is diagnosed, surgery is the most standard approach used, with a hysterectomy, or even a “complete” hysterectomy, which involves the removal of the fallopian tubes and ovaries in addition to the uterus, being common. Additional treatment with chemotherapy or radiation is often required. Follow up treatment using progestin, a synthetic version of the hormone progesterone, may be recommended in order to prevent the cancer spreading to other parts of the body.
