“I went through Menopause 3 years ago, now I am having a period out of the blue! Is this a problem?”

The short answer is…”We don’t know until we check it out”. Postmenopausal bleeding has many causes from tearing of the fragile vaginal tissue to sores on the labia to lesions and/or cancer in the uterus. Some of these are quite significant, others less so. Are you over 70 and/or diabetic? Are you overweight? Have you ever been pregnant? Are you on hormone therapy? These are a few of the questions we will need to ask.

If YOU have any postmenopausal bleeding (from spotting to a full blown “period”), it is important to have it evaluated. You’ll need to come in for an exam and to talk to one of our health care providers about your bleeding. Whenever a woman does have bleeding after menopause, pathology needs to be ruled out, like pre-cancerous or cancerous changes in the uterus. Sometimes, an ultrasound is ordered to assess the thickness of the uterine lining. It is less concerning when the lining is thin. Other times, an endometrial biopsy is done, using a “Pipelle”. A “Pipelle” is a small tube that slides through the cervix and into the uterus. When in place, a small amount of suction is created to obtain a sample from the uterus (kind of like a straw). Still other times, a saline infusion sonogram is ordered to see if there are any polyps or growths in the uterus. (A saline infusion sonogram is an ultrasound that is accompanied by the introduction of a sterile saline solution in the uterus).

Most of the time, the postmenopausal bleeding is due to a benign, or non-cancerous cause. However, it is imperative to make SURE it is not cancer.

Reference: Menopause e-consult, North American Menopause Society. July, 2011

Susan Vendeland, ARNP

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