118: Postmenopausal Bleeding: Causes, Concerns, and When to Seek Help

Dear Menopause

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22d ago 14:32

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Postmenopausal bleeding can be an alarming experience, especially when you've gone years without a period. What causes this unexpected bleeding? When should you be concerned?

Dr Ceri Cashell joins me to demystify this common but often distressing symptom.
We dive into the definition of postmenopausal bleeding - any bleeding that occurs after 12 months without periods - and explore the various causes, from hormone imbalances to more serious conditions that require immediate attention. Dr Ceri uses a brilliant analogy, comparing the uterus to a jumbo jet where multiple hormone "switches" need perfect alignment for smooth operation.
For women recently started HRT, bleeding can be a side effect, particularly in the first three to six months or after dosage adjustments. However, Dr Ceri emphasises that certain risk factors like obesity, family history, tamoxifen use, and smoking warrant prompt investigation.

We walk through exactly what happens during medical assessment - from initial GP visits to ultrasounds that measure endometrial thickness and potentially hysteroscopy procedures.
My own experience with unexpected bleeding after eight years without periods highlights how confronting this symptom can be.

Dr. Ceri reminds us that while HRT offers tremendous benefits, it's not a perfect solution and may require personalised adjustments to find your hormone sweet spot. Most importantly, she urges women not to dismiss or normalise symptoms that could indicate something serious - "Women are far too good at sucking things up," she notes, encouraging listeners to prioritise their health concerns.
Have you experienced unexpected bleeding after menopause? Don't wait - speak with your healthcare provider today and get the answers and reassurance you deserve.

Links

Healthy Hormones Website

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Chapters

1. Welcome to Dear Menopause Podcast (00:00:00)

2. Defining Postmenopausal Bleeding (00:00:54)

3. Common Causes and Hormone Imbalances (00:02:02)

4. When to See Your Doctor (00:03:41)

5. The Investigation Process (00:04:45)

6. Managing Persistent Bleeding (00:08:27)

7. Final Thoughts and Resources (00:12:47)

121 episodes

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