Mayo Clinic Q and A: Spotting, perimenopause and menopause

Other underlying medical concerns that may lead to vaginal bleeding after menopause include conditions that thin the tissue that lines the ... ByCynthiaWeiss MayoClinicQandA:Spotting,perimenopauseandmenopause December21,2020 DEARMAYOCLINIC: Iam52andrecentlyhadgone10monthswithoutaperiod,soIhadassumedIwasinmenopause.But,overthepastthreemonths,I'venoticedsomelightspotting.DoesthismeanI'mnotinmenopause?HowdoIknowwhenI'minmenopause,anddoIneedtoseeagynecologistorhealthcareprovideraboutthisissue? ANSWER: It'spossiblethatyouhaven'treachedmenopauseyet.Clinically,menopauseisdefinedasgoingwithoutaperiodforoneyear.At10months,youdon'tquitemeetthatthreshold,butitispossiblethatyouarejustbeginningmenopause.However,dependinguponwhenyoulastsawyourhealthcareproviderandhadapelvicexam,itmightbeworthwhiletomakeanappointment,asthereareanumberofconditionswherebreakthroughbleedingisthefirstindicationofanissue. Menopauseisthenaturalprocessthatmarkstheendofawoman'sreproductiveyearswhenmenstrualcyclesstop.Ittypicallyhappensduringthe40sor50s,withtheaverageageofmenopauseintheU.S.at51. Skippingperiodsasyouapproachmenopause—astagesometimescalledperimenopause—iscommonandexpected.Duringthattime,menstrualperiodsoftenwillskipamonthandreturn,orskipseveralmonthsandthenstartmonthlycyclesagainforafewmonths.Periodsalsotendtohappenonshortercyclesduringperimenopause,sotheymaybeclosertogetherthanistypicalforyou. Tenmonthsbetweenperiodsislongerthanusualintheperimenopausestage.Butitispossible,andthespottingyou'venoticedmaynotsignalanythingotherthanthefactthatyourbodyisn'ttomenopauseatthispoint.However,ifyouhavegonethroughmenopause,thenthebleedingcouldbecauseforconcern. Bleedingaftermenopauseisnotnormal,anditmustbeevaluatedbyahealthcareprovider.Postmenopausalbleedingcanhavevariouscauses. Oneofthemostseriousunderlyingconditionsthatcouldleadtothistypeofbleedingiscancer.Forexample,cancerthatbeginsintheuterus,calledendometrialcancer,oftentriggersabnormalvaginalbleeding.Formanywomenwiththisformofcancer,bleedingistheironlysymptomanditisoftenpainless.That'swhyit'ssoimportanttohavepostmenopausalbleedingevaluatedassoonaspossible,evenifitisonlylightspotting. Ifyourhealthcareprovidersuspectsendometrialcancer,itmightberecommendedtoremoveasampleoftissuefromyouruterineliningwithaprocedurecalledendometrialbiopsy.Thetissuethat'sremovedthenisexaminedinalaboratoryforsignsofcancer.Anendometrialbiopsymaybeperformedinyourhealthcareprovider'soffice,anditusuallydoesn'trequireanesthesia. Lesscommonkindsofcancerthatalsocouldcauseabnormalbleedingarecancerofthecervixorvagina,aswellasuterinesarcoma.Otherunderlyingmedicalconcernsthatmayleadtovaginalbleedingaftermenopauseincludeconditionsthatthinthetissuethatlinestheuterusorthevagina,calledendometrialatrophyandvaginalatrophy.Insomecases,uterinefibroidsorpolypsmaytriggerbleeding,too. Thebleedingalsocouldbetheresultofaconditionknownasendometrialhyperplasia,inwhichthereisaprecancerousovergrowthofcellsthatmakeuptheuterinelining.Aninfection,injuryorotherpelvictrauma,andcertainmedicationsalsohavebeenknowntocausepostmenopausalbleeding.Despitethislistofdisconcertingpossibilities,pleaseknow,too,thatthebleedingyouareexperiencingmaybeharmless,withoutanyseriousunderlyingmedicalconditioncausingit.But,atthistime,youshouldseeyourhealthcareprovidertofindoutwhat'sgoingon.—Dr.JamieBakkum-Gamez,OB-GYN,MayoClinic,Rochester,Minnesota **************************** RelatedArticles  MayoClinicQandA:Understandingendometrialcancer published9/30/20Women’sWellness:Researcherslookatpostmenopauseaskeyfactorinendometrialcancer published1/30/20Women’sWellness:Menopausemisconceptions published5/16/19 MayoClinicQandA:Familyhealthhistoryinformation ConsumerHealth:Gettingthenutritionyouneedduringcancertreatment FeaturedNews ByLaurelKelly August2,2022 Share Facebook Twitter LinkedIn Email Print Cancel ConsumerHealth:Supportforbreastfeeding ByJenniferO'Hara August2,2022 Share Facebook Twitter LinkedIn Email Print Cancel MayoClinicQ&Apodcast:Cancerrehabilitation ByJoelStreed August1,2022 Share Facebook Twitter LinkedIn Email Print Cancel 8-1-2022MediaOnlyNewsBriefing:Reducinghealthdisparitiesandaddictivenessincigaretteproducts ByDanLea August1,2022 Share Facebook Twitter LinkedIn Email Print Cancel Syphilis:Arisingcommunitypresence MayoClinicNewsArchive Loading... Loading... version3.3.6.2.7.6Pageloadedin0.129seconds