Postmenopausal bleeding is vaginal bleeding that occurs a year or more after your last menstrual period. It can be a symptom of vaginal dryness, polyps (noncancerous growths) or other changes in your reproductive system. In about 10% of women, bleeding after menopause is a sign of uterine cancer.

Postmenopausal bleeding is bleeding that occurs after menopause. Menopause is a stage in a woman’s life (around age 51) when reproductive hormones drop and her monthly menstrual periods stop. Vaginal bleeding that occurs more than a year after a woman’s last period isn’t normal. The bleeding can be light (spotting) or heavy.

Symptoms of Postmenopausal bleeding

Many women who experience postmenopausal bleeding may not have other symptoms. But symptoms may be present. This can depend on the cause of bleeding.

Many symptoms that occur during menopause, like hot flashes, often begin to decrease during the postmenopausal time period. There are, however, other symptoms that postmenopausal women may exper    ience.

Symptoms postmenopausal women may experience include:

• vaginal dryness
• decreased libido
• insomnia
• stress incontinence
• increased urinary tract infections
• weight gain

Causes of Postmenopausal bleeding

The most common causes of bleeding or spotting after menopause include:

• Endometrial or vaginal atrophy (lining of the uterus or vagina becomes thin and dry).
• Hormone replacement therapy (HRT) (estrogen and progesterone supplements that decrease some menopausal symptoms).
• Uterine cancer or endometrial cancer (cancer in the lining of the uterus).
• Endometrial hyperplasia (the lining of the uterus gets too thick and can contain abnormal cells).
• Uterine polyps (growths in the uterus).

Other causes can include:

• Cervical cancer (cancer in the cervix).
• Cervicitis or endometritis (infection or inflammation in the cervix or uterus).
• Bleeding from other areas, nearby, in the bladder or rectum or bleeding from the skin of the vulva (outside near the vagina).

Diagnosis of Postmenopausal bleeding

A doctor will start an exam for postmenopausal bleeding by asking the woman about the symptoms she may be experiencing. A doctor will likely ask:

• when she first noticed her symptoms
• how much she bleeds
• if she has any family history of postmenopausal bleeding

Depending upon a woman’s symptoms, a doctor may recommend one or more of a number of tests.

Examples of tests used to diagnose the cause of postmenopausal bleeding include:

• Dilation and curettage (D&C): This procedure involves dilating or widening the cervix to obtain a larger tissue sample. It also involves using a special tool called a hysteroscope to see inside the uterus to identify any potential growths.
• Endometrial biopsy: This procedure involves inserting a small, thin tube into the vagina to reach the cervix to take a sample of tissue lining from the uterus. This tissue can then be tested for the presence of abnormal cells, such as cancerous cells.
• Hysteroscopy: This procedure involves a doctor inserting a tool with a thin, lighted camera on the end to examine the inside of the uterus and its lining. The approach can help a doctor to identify polyps or abnormal growths.
• Sonohysterography: This procedure involves injecting fluid through the vagina and into the uterus. A doctor will then use an ultrasound machine – which uses sound waves to identify differences in tissues – to visualize the uterus. This is known as a transabdominal ultrasound. The process can allow a doctor to determine whether the uterine lining is thicker or thinner than expected.
• Transvaginal ultrasound: This procedure involves inserting a special ultrasound probe into the vagina to allow a doctor to visualize the uterus from the bottom of the uterus, instead of from the lower abdomen.

HomeopathicTreatment of Postmenopausal bleeding

SABINA  - Sabina is one of the top remedies for dysfunctional uterine bleeding with sexual excitement. The blood is partly fluid and partly clotted.  Menses too profuse too early, gushing of hot watery bright red blood mixed with clots. Severe uterine pain extend into thighs. Pain from sacrum to pubis and from below upwards. Shooting pain up the vagina. Another symptom is increased desire for sex.

THLASPI BURSA PASTORIS - Thlaspi bursa pastoris another effective remedy for dysfunctional uterine bleeding with violent uterine pains , which is colicky or cramping in nature. Every alternate period very profuse. Leucorrhea before and after menses, bloody dark offensive. Sore pain in uterus on rising. Scarcely recovers from one period before another begins. Backache accompanied with bleeding. Large clots may  accompanying  the blood. Bleedimna may be due to fibroids, or cancer of uterus.

TRILLIUM PENDULUM - Trillium pendulum is one of the top remedies for dysfunctional uterine bleeding with severe pain. In hip and back. Menses even two weeks. Uterine haemorrhages with sensation as though hip and back were falling to pieces, better tight bandages. Gushing of bright blood on least movement. Hemorrhage due to uterine fibroids. There is a feeling of bearing down sensation, prolapsed uterus.

CHINA OFF - China is prescribed for dysfunctional bleeding with fainting, convulsions and great weakness. The blood is dark in color. Menses too early, dark, profuse, clotted with abdominal distension.

CALCAREA CARB  - Calcarea carb is excellent for dysfunctional uterine bleeding with headache, colic , chilliness and leucorrhea. Cutting pain in uterus during menstruation. Menses too early, too profuse, too long with vertigo, toothache and cold damp feet, the least excitement causes their return. Calcarea carb persons are fat, flabby and fair. They have a special craving for boiled eggs and indigestible things like chalk, pencils etc. Bleeding due to uterine fibroids.

PHOSPHORUS - Phosphorus is prescribed for frequent and profuse or short uterine bleeding between the periods due to fibroids, uterine polyps or cancer. This may also happens in nursing women. Menses too early and scanty, not profuse , but last too long.

SEPIA - Sepia is effective for dysfunctional uterine bleeding during menopause. Along with bleeding menopausal symptoms like hot flushes, irritability and sadness are seen.  Indifferent to her loved ones.  There is a feeling of bearing down sensation in the uterus.

CHAMOMILLA - Chamomilla is effective is effective for dysfunctional uterine bleeding from anger with forcing pains. Flow dark and clotted.

AMBRA GRISEA - Ambra grisea is considered for discharge of blood between periods , due to exertion, at least incident. Worse after hard stools, walking a little longer etc.

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