Why Am I Bleeding? Understanding Abnormal Bleeding During Menopause
What’s Normal and What’s Not?
Menopause is a time of transition, and with it can come changes in your menstrual cycle. Some irregularity is expected during perimenopause, but if you’re experiencing heavy, prolonged, or unexpected bleeding, it’s time to pay attention. While most causes are benign, abnormal bleeding can sometimes indicate an underlying issue that needs medical attention.
Here’s what you need to know about the potential causes of abnormal bleeding—and when to see your doctor.
Common Causes of Abnormal Bleeding
1. Adenomyosis
Small areas of the uterine lining can grow into the muscular wall of the uterus, causing heavy bleeding and painful periods. The good news? These symptoms usually resolve after menopause.
2. Anovulation (When You Don’t Ovulate)
If your ovary skips ovulation during a cycle, it can lead to irregular bleeding. Many factors can affect ovulation, including:
• Stress
• Obesity
• Eating disorders
• Significant weight loss
• Intense exercise
• Polycystic ovary syndrome (PCOS)
3. Fibroids
These noncancerous muscle tumors develop in and around the uterus and can cause:
• Heavy bleeding and cramping
• Pelvic or back pain
• Frequent urination or constipation
• Pregnancy loss
Fibroids typically shrink after menopause, but hormone therapy (HT) may slow this process.
4. Hormonal Imbalances
Fluctuations in estrogen and progesterone can cause irregular or heavy bleeding. Other hormonal issues, such as an underactive thyroid (hypothyroidism), can also affect your menstrual cycle.
5. Medications & Hormone Therapy
Certain prescription medications, including birth control and hormone therapy (HT), may lead to irregular bleeding. If this happens, talk to your doctor about possible adjustments.
6. Uterine-Lining Abnormalities
• Polyps: Noncancerous growths in the endometrium that can lead to irregular bleeding.
• Endometrial Hyperplasia: A precancerous thickening of the uterine lining that requires medical evaluation.
7. Cancer (Rare, But Important to Rule Out)
Cancer of the uterus, cervix, or vagina can sometimes present as abnormal bleeding. Regular pelvic exams and Pap smears help detect these conditions early when they are most treatable.
8. Other Causes
• Medications: Blood thinners, aspirin, corticosteroids, and some herbal supplements can interfere with clotting and lead to unexpected bleeding.
• Bleeding Disorders: Some women have inherited conditions that affect blood clotting.
• Infections: Pelvic inflammatory disease (PID) and infections of the vagina or cervix can also trigger abnormal bleeding.
When to Call Your Doctor
It’s important to track your bleeding and discuss any concerns with a healthcare professional, especially if you experience:
✅ Heavy bleeding that soaks through pads or tampons quickly
✅ Bleeding that lasts longer than usual or occurs between periods
✅ Bleeding after sex
✅ Any vaginal bleeding after menopause
While most causes of abnormal bleeding are treatable, early diagnosis is key to managing your health effectively.
Let’s Talk About It!
Navigating menopause can feel overwhelming, but you’re not alone. At Menopausia.com, we provide expert advice, community support, and trusted resources to help you through every stage. Join us today and take control of your menopause journey!
