If you haven't had a period for a long time and think you are well into the menopause, vaginal bleeding can cause you a great deal of concern. Don't panic though; there are a number of possible reasons for your bleed. Even if the bleeding does turn out to be a sign of something more serious, getting a diagnosis and early treatment should ensure you can solve the problem.



The first possibility is that you are still having occasional periods. As women go through the menopause their cycles often become irregular and missed periods are common. They can become lighter and shorter or heavier and longer; all women are different. Although women are classed as being post menopausal when they haven't had a period for a year, they may still have an occasional period after this time.

Once you really are post menopausal, there are other possible reasons for bleeding. Decreased levels of estrogen mean the walls of the vaginal become thinner and generally more prone to bleeding, especially after sexual intercourse. You may also experience bleeding due to a vaginal infection, or growths in the uterus. A trip to your doctor or gynecologist should put your mind at rest in these cases.

The most serious possible cause of vaginal bleeding is cancer of the uterus, known as endometrial cancer. There is a fairly high incidence of this cancer in North America, with 40,000 new endometrial cancer cases and 7,500 deaths predicted for 2007. Women are more at risk when they are undergoing Hormone Replacement Therapy (HRT) that only involves estrogen and not progesterone, as progesterone protects the lining of the uterus.

The sooner endometrial cancer is diagnosed, the more chance there is of an effective cure. Vaginal bleeding is a very early indicator of this disease, so you should always consult your doctor if you experience unexplained vaginal bleeding.

Typically, bleeding caused by endometrial cancer has certain characteristics. Women usually experience a watery, blood streaked flow, with the proportion of blood gradually increasing over time. This may be accompanied by pain whilst passing urine, pain in the pelvis and pain during sexual intercourse. Of course these three additional symptoms can be indicators of other post menopause problems so don't panic, but do mention them to your doctor.

If your doctor suspects possible endometrial cancer they will usually perform a transvaginal ultrasound so see if the endometrium, or uterus lining, is unusually thick. If it is they will then recommend a biopsy where a sample of the tissue form the lining of the uterus is removed and sent for laboratory testing.

If you experience post menopausal bleeding, there is most likely a simple explanation. However, if you are worried you should always consult your doctor or gynecologist. At the very least they will be able to put your mind at rest, or prescribe something to ease your symptoms. In the worst case, a trip to the doctor for early diagnosis and treatment could actually save your life.