Can Periods Restart After Menopause: Understanding the Possibility of Postmenopausal Bleeding

Maanvi Kashyap
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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can periods restart after menopause

Menopause is officially recognized when a woman has experienced the absence of menstrual periods for a continuous period of 12 months.

However, there are instances where women may experience the return of periods or unexpected bleeding even after reaching Menopause.

Approximately 4-11% of women after Menopause experience vaginal bleeding.

While uncommon, this occurrence can happen within a few months or several years after the last period. 

Hormonal fluctuations during Menopause and other factors can sometimes cause irregular periods before they eventually stop altogether. 

Understanding the possibility of periods restarting after Menopause can help women navigate this transitional phase and seek appropriate medical attention if needed.

Continue reading the article to know more about “Can Periods Restart After Menopause?”.

Can periods restart after Menopause

Menopause is the end of a woman’s reproductive years. 

It occurs when the ovaries produce fewer hormones, leading to the cessation of menstrual periods. 

While it is uncommon, some women may experience the return of periods or unexpected bleeding even after reaching Menopause. 

This is known as Postmenopausal bleeding, also known as postmenopausal vaginal bleeding (PMB).

This occurrence can happen within a few months or several years after the last period. 

Although it might come as a surprise, it is not entirely unheard of.

During Menopause, hormonal fluctuations can still occur, resulting in occasional breakthrough bleeding or irregular periods. 

These hormonal changes can disrupt the previously established pattern of no menstrual bleeding. 

While the return of periods after Menopause can be concerning, it is essential to remember that each woman’s experience is unique.

Possible causes of postmenopausal bleeding

Postmenopausal bleeding can have various underlying causes. 

While some reasons may not be serious, others could indicate more significant health issues. 

Here are a few potential causes:

Hormonal changes

Fluctuations in hormone levels during perimenopause and Menopause can occasionally trigger the reoccurrence of periods or irregular bleeding.

Vaginal Intercourse

Engaging in vaginal intercourse after Menopause can sometimes cause postmenopausal bleeding. 

This can occur due to the thinning of vaginal tissues and increased sensitivity, making them more prone to irritation or injury during sexual activity.

Sexual Trauma

Past sexual trauma or recent sexual assault can potentially lead to postmenopausal bleeding. 

Trauma to the reproductive organs can cause damage to the delicate tissues, resulting in bleeding.

Endometrial Cancer

Endometrial cancer is a type of cancer that affects the lining of the uterus. 

One of the common symptoms of Endometrial cancer is postmenopausal bleeding.

Around 9% of women who sought medical attention for bleeding after menopause were eventually diagnosed with endometrial cancer.

Cervical cancer

Cervical cancer refers to cancer that develops in the cervix. 

Postmenopausal bleeding can be an indication of cervical cancer.

Ovarian cancer

While less common, ovarian cancer can also cause postmenopausal bleeding. 

Ovarian cancer affects the ovaries, and abnormal bleeding can be one of the signs or symptoms.

Hormone Replacement Therapy (HRT)

Applying hormone replacement therapy patchSource: recep-bg_from_Getty_Images
Applying HRT patch

Women undergoing hormone replacement therapy to manage Menopausal symptoms may sometimes experience bleeding or spotting.

Uterine or cervical abnormalities

Growths such as Polyps, Fibroids, or abnormal cells in the uterus or cervix can cause postmenopausal bleeding.

Fact:
Polyps are growths of the tissue that lines the uterus, called the endometrium.
On the other hand, fibroids are made of a combination of connective tissue and muscle cells.
Although they share some symptoms, it is crucial to receive a proper diagnosis.
Polyps usually stay small, while fibroids can grow so large that they stretch the uterus.

Infections or inflammation

Inflammation and thinning of the vaginal lining (Atrophic Vaginitis) or womb lining (Endometrial Atrophy) can occur due to lower Estrogen levels during Menopause. 

These changes can contribute to postmenopausal bleeding and discomfort.

Medications

Certain medications can increase the likelihood of postmenopausal bleeding or cause it as a side effect. 

These medications include hormone therapy, Tamoxifen (used for breast cancer treatment), blood thinners, SSRIs, Tricyclic antidepressants, and Antipsychotic medications. 

When taking these medications, it’s essential to be aware that they can lead to PMB.

Caution:
If you are taking these medications and experiencing vaginal bleeding, consult a doctor immediately.

Evaluation and diagnosis

When visiting a healthcare provider for postmenopausal bleeding, they will thoroughly evaluate the cause. 

This may involve:

Medical History

The patient’s medical history plays a crucial role in evaluating postmenopausal bleeding. 

Determining the menopausal status is essential, considering the last menstrual period or surgical history. 

Past testing, such as follicle-stimulating hormone levels, can aid in confirming menopause.

History of Present Illness

Understanding the nature of the patient’s prior menstrual cycles and current bleeding is essential. 

Details about heavy bleeding, abnormal uterine bleeding, and the pattern of postmenopausal bleeding provide valuable clues to potential causes.

Past Medical History

Certain medical conditions or factors like obesity, Polycystic Ovarian Syndrome, Diabetes, or Tamoxifen use may increase the likelihood of certain abnormalities. 

Information about recent Pap tests and history of radiation exposure is also essential.

Social History

Social factors like sexual activity, infections, smoking, or exposure to certain substances should be considered. 

They can provide insights into potential causes of postmenopausal bleeding.

Family History

A family history of cancer, including breast, gynecologic, urologic, or gastrointestinal cancers, may be relevant and help identify potential risks.

Medications

Knowing the medications a patient is taking is crucial. 

Postmenopausal hormone therapy, herbal supplements, and anticoagulation can contribute to vaginal bleeding.

Physical Examination

A comprehensive physical examination of the genital tract is necessary. 

Identifying any bleeding sites, lesions, lacerations, or signs of atrophy or inflammation provides valuable information. 

Evaluating the uterus’s size, shape, and tenderness helps narrow down potential causes.

Systemic Examination

A general systemic examination is essential to identify signs of underlying chronic or severe illness that may contribute to postmenopausal bleeding.

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Treatment Options

Consult a gynecologistSource: Wavebreakmedia_from_Getty_Images
Consult a Gynecologist

The treatment for postmenopausal bleeding depends on the underlying cause. 

Sometimes, no specific treatment may be required, mainly if the bleeding is benign. 

However, if an underlying condition is identified, appropriate interventions may include:

  • Hormonal therapy – In certain situations, hormonal treatments may be prescribed to regulate the uterine lining and reduce bleeding.
  • Removal of uterine growths – Surgical procedures, such as hysteroscopic polypectomy or myomectomy, may be performed to remove polyps or fibroids causing bleeding.
  • Medication adjustments – Your healthcare provider may adjust the dosage or recommend alternative options if medications contribute to postmenopausal bleeding.

Takeaway

Menopause is when there has been no menstrual period for 12 consecutive months. 

However, it is possible for periods to restart or experience postmenopausal bleeding, although uncommon. 

This can occur due to hormonal fluctuations, vaginal intercourse, sexual trauma, and underlying health conditions such as endometrial, cervical, or ovarian cancer. 

An evaluation may involve medical history, physical examination, and additional tests. 

Treatment options depend on the specific cause and may include hormonal therapy, removal of uterine growths, or medication adjustments. 

Remember to consult a healthcare professional for personalized advice and guidance if experiencing postmenopausal bleeding.

Frequently Asked Questions

Is it possible to have a period of 2 years after Menopause?

It is generally unlikely to have a period two years after Menopause. Menopause is confirmed when a woman has not had a period for 12 consecutive months. However, in some rare cases, hormonal fluctuations or other factors may cause unexpected bleeding after Menopause. If this happens, consult a doctor immediately.

Can you suddenly have a period after Menopause?

Sometimes, it is possible to have a period after Menopause suddenly. This can occur due to hormonal fluctuations or changes in the uterine lining. While uncommon, consulting with a healthcare provider to evaluate the cause and address any concerns is essential.

Can your period stop and start again during Menopause?

Yes, it is possible for periods to stop and start again during Menopause. Hormonal fluctuations can cause irregular periods before they eventually stop altogether. This irregularity is a normal part of the menopause transition, but consulting with a healthcare professional for any concerns is still essential.

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