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Postmenopausal bleeding: Do you have cancer?

What is postmenopausal bleeding?

  • If you are in menopause and have any vaginal bleeding, even occasional spotting or a light period like bleed, even only once, you need to see your physician and possibly a Gynecologist.
  • This is called postmenopausal bleeding.

Why are we concerned?  

  • Any bleeding in menopause could be a sign of precancer or cancer of the uterus lining, called Endometrial Cancer.
  • Other cancers can also have similar bleeding in that area, such as from the Vagina, the cervix, the bladder (especially if there is blood in your urine.) or the anal and rectal area.

What is menopause?

  • Menopause is the time after your periods stop. Menopause usually occurs in your late 40’s.
  • Strictly speaking once you have had no bleeding for 1 year, we call that menopause.

What is Perimenopause?

  • Leading up to menopause, you may have irregular bleeding, energy changes, mood changes, headaches, hot flashes or night sweats, due to the hormones from your ovaries slowing down.

Should I be worried if I have irregular periods or vaginal bleeding?

  • Yes, any irregular bleeding especially after 40 years old or if you have other risk factors such as being overweight or have PCOS, can be due to precancerous changes or cancer.

Does endometrial cancer occur in young women who still have periods?

  • Yes, we have diagnosed young women with endometrial cancer at 32yo and many young women with precancerous changes called atypical hyperplasia or Endometrial intraepithelial neoplasia (EIN)

What test should you have done if you have irregular or postmenopausal bleeding?

  • A full pelvic examination, including the vagina and the cervix.
  • A Pelvic ultrasound, including in the vagina if possible, to look at the uterus lining for abnormal changes.
  • If there is a concern of endometrial cancer, a small clinic procedure or sampling of the lining is the only way to make a diagnosis.

Final word:

  • If you are in menopause and have any bleeding or pink or brown discharge from the vagina, even if you think it is nothing, please see your Family Physician of Gynecologist to get an ultrasound of the uterus, to have a vaginal examination and to possibly have sampling done of the uterus lining.

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