Is Spotting after Menopause Cause For Concern?

If your menstrual period has ceased for longer than a year and you suddenly begin to experience any amount of vaginal bleeding, don’t wait to contact your gynecologist. Unlike spotting which may occur before the onset of menopause, any signs of bleeding afterwards needs to be checked out.

Pre-menopausal spotting can be caused by simple menstrual cycle variations, ovulation, infection, miscarriage, cancer, or a host of other conditions and circumstances. Prior to its onset, spotting may actually be a symptom of menopause. But spotting after menopause is a different situation entirely.

Oftentimes spotting after menopause occurs in response to the beginning of Hormone Replacement Therapy. HRT changes or missed doses may be the culprit. Steroid usage or taking aspirin at high doses could cause mild vaginal bleeding. Something as simple as stress can cause spotting after menopause - but so can cancer.

Your gynecologist will perform one or a combination of testing procedures to evaluate your condition and determine the likely cause before prescribing any treatment. Usually initial testing involves:

• Blood tests to check for anemia and to measure hormonal levels.


• Internal examination to check for visible sources of bleeding and/or enlargement of the uterus


• Pap test (cervical smear) to check for changes in the cells of the cervix


• Speculum examination in which the cervix can be viewed through a special instrument via the vagina.

Your doctor may also carry out additional testing, including:

• D & C: dilating the cervix and scraping the uterus lining


• Hysteroscopy: examining the uterus with a specially designed telescope inserted through the cervix. Biopsies may also be taken.


• Ultrasound: measures the thickness of the lining of the uterus


• Vaginal Ultrasound: internal ultrasound via the vagina


• Combination of D & C and Hysteroscopy

Following testing, your gynecologist or doctor will prescribe an appropriate treatment. In the case of an infection, antibiotics may be prescribed. Sometimes HRT regimens need to be re-evaluated and adjusted. If small, benign tumors (fibroids or polyps) are causing spotting after menopause, they may be removed by a simple surgical procedure.

If testing reveals that cancer either of the cervix or uterus is present, more intensive treatments are likely to be required. In some cases, a hysterectomy may be the sensible choice of treatment for cancer of the reproductive organs. Your doctor will be able to provide in-depth information about any surgical procedures that may be necessary.

Spotting after menopause may or may not be cause for concern, but there’s only one way to find out. Make an appointment with your gynecologist right away if you experience post-menopausal vaginal bleeding to avoid taking unnecessary risks with your health.