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Dr. Andrew Rynne

Family Physician

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Is it normal to get period or spotting after menopause?

Mar 2013
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Practicing since : 1998
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I am a 60 year old female and haven't had a period in 12 years. in the last 2 weeks i have had bleeding. The first time was very light and only lasted 2 days. 3 days ago I started again. This time feeling more like a normal period. Is this normal. I don't really have pain. Only slight discomfort off and on, primarily on the left side ovary area.
Fri, 1 Feb 2013 in Menstruation and Miscarriage
Answered by Dr. Aarti Abraham 2 hours later
Thanks for writing to us.
If you have gone without menstrual bleeding for more than a year, it is defined as Menopause, and ANY kind of menstrual bleeding, even spotting, is not normal after menopause.

Please make an appointment with your Gynecologist at the earliest, as this could be caused by a variety of reasons, that I am listing below, and some of them are serious.

1. Polyps, which are usually non cancerous growths, which develop on the uterus or the cervix.
2. Endometrial hyperplasia - This is thickening of the lining of the uterus, which might occur in postmenopausal women due to hormonal imbalances, and some forms of hyperplasia predispose to endometrial cancer. Obesity, diabetes, history of polycystic ovaries and hypertension are factors which add to the risk.
3. Endometrial atrophy - Extreme thinning of the lining of the uterus, which then breaks down and causes spotting/ bleeding.
4. Hormonal therapy, treatment with blood thinners, etc
5. Cancer of the cervix or adjacent organs might first be heralded by post menopausal bleeding.
6. Infections or senile postmenopausal atrophy of the vagina or uterus

For differentiating between these causes, your gynaecologist would perform a thorough systemic bodily examination, per vaginal and per speculum examination, as well as a pelvic examination.
An ultrasound, Pap test, or endometrial biopsy might be ordered.
Sometimes, a hysteroscopy, that is, visualisation of the interior of the uterine cavity with a telescope might be warranted.
D and C ( dilatation and curettage ) might be indicated for obtaining tissue for analysis from the uterus and cervical canal.

Treatment too obviously depends on the pathology found. Apart from cancers, most conditions are treated by minor surgical procedures / hormonal or other medication.

Take care and go for your check up at the earliest.
Please feel free to ask for further clarifications.

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