Written by John Matthews - January 04, 2023
The answer to this important question can vary depending on the circumstances of a woman’s health. There are, however, some explanations that may be behind this condition.
Hormonal Imbalance
A hormone imbalance can cause bleeding years after menopause is complete. This can happen when a woman is unable to produce enough hormones due to a low ovarian reserve, or when other hormones become unbalanced in the body. Some common causes of hormonal imbalance include:
These imbalances can lead to irregular periods and sometimes even postmenopausal bleeding. It's important for women to speak with their doctor about any changes in their period or symptoms of hormonal imbalance after menopause for an accurate diagnosis and treatment plan.
Endometrial hyperplasia is the thickening of the uterine lining due to an excess of estrogen without progesterone being present, known as unopposed estrogen. This occurs more often in women receiving hormone replacement therapy than those who aren't taking hormones. With endometrial hyperplasia, there is an increased chance of postmenopausal bleeding or abnormal spotting between periods. If untreated, it can lead to precancerous changes in the uterus that require medical attention through medications or surgically removing part of or all of the uterus (hysterectomy).
Uterine fibroids are noncancerous growths made from muscle cells and connective tissue that grow inside or around the uterus. They often occur during childbearing years but can also be found later in life, including after menopause has occurred. Fibroids can cause heavy menstrual bleeding and longer-than-normal periods throughout a woman’s life — including after menopause — because they increase estrogen production within the body which affects how your reproductive system works overall. If severe enough, they may require surgery to remove them completely if other treatments do not improve symptoms over time.
Endometrial cancer is a rare cause of postmenopausal bleeding but it should not be ignored as it could indicate something much more serious going on in your body that requires immediate medical attention from your doctor or gynecologist. Risk factors for endometrial cancer include obesity, diabetes, never having children, taking tamoxifen for breast cancer treatment, prior radiation treatments for cancers such as cervical or ovarian cancer and older age at time of first pregnancy (over 30 years old).
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