After menopause, spotting is cause for concern

Postmenopausal bleeding is always something to get checked out right away. I know — I can practically hear the question forming in your mind: How do I know I’m postmenopausal and not still in the seemingly eternal middle of menopause?

Here’s a rule of thumb: If you haven’t had a period for 12 consecutive months, you’re postmenopausal.

After you’ve met the year landmark, any spotting is cause for concern. Any spotting. Here’s what spotting might indicate:

  • Polyps — noncancerous growths that occur in the uterus or on the cervix.
  • Endometrial atrophy — thinning of the tissue that lines the uterus. Decreased estrogen levels cause the lining to thin, and that leads to bleeding.
  • Endometrial hyperplasia — thickening of the lining of the uterus because of high estrogen levels. Some women who have this condition also have abnormal cells in the lining that could lead to cancer of the uterine lining.
  • Endometrial cancer — cancer in the uterine lining.

Hormone therapy, infections, and certain medications can also cause postmenopausal bleeding.

If you’re spotting — even a little — a number of tests get to the bottom of it.

  • A pelvic exam can reveal whether your uterus is enlarged and whether you have cervical polyps.
  • A pelvic ultrasound lets your healthcare provider examine the lining of your uterus and to find polyps, fibroids, and other conditions that may cause bleeding.
  • An endometrial biopsy, which takes place in the office, collects a tiny sample of the uterine lining, which a pathologist then evaluates.
  • Surgical procedures such as a hysteroscopy and a D&C are usually performed together: the hysteroscopy gives the doctor a look at the uterine lining and tissue from the uterine lining is removed during the D&C.

Medication may be the answer for endometrial hyperplasia, but surgery often is necessary. Polyps also generally require surgery. If endometrial cancer is causing your bleeding, then hysterectomy is the treatment.

Remember, if you have any postmenopausal bleeding please contact your doctor right away for an evaluation. Postmenopausal bleeding is not normal no matter how light it is.

If you have questions about postmenopausal bleeding — or any other health concern — all 317-338-4-HER to talk to a registered nurse or use this form to talk to me directly.

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