Transitioning into menopause comes with a lot of changes to your body—most notably, the permanent end of your menstrual cycle. Although menopause comes with some frustrating symptoms (hot flashes, insomnia), no longer having a period is, unsurprisingly, a welcome change for many women. Goodbye, pads and tampons! Hello, white pants!

Once you have gone 12 months without menstruating, you have officially reached menopause. After getting to this point, it can be a bit unsettling if you start bleeding again. You know it can’t be your period— so, what is it?

Is Postmenopausal Bleeding Normal?

No, postmenopausal bleeding is not normal. It is usually not a sign of anything serious, but there are cases where it is a symptom of gynecologic cancer (usually uterine or cervical cancer).

If you notice bleeding after reaching menopause, try not to panic but do act quickly. Call your Mercy doctor straightaway and schedule an appointment.

It may be tempting to minimize postmenopausal bleeding if it’s not having much of an impact on your day-to-day life. You’re busy and don’t want something else added to your plate.

• You have only bled once
• You are only lightly spotting
• You can’t tell if the discharge is blood or not
• The discharge is pink or brown
• You are not experiencing any other symptoms

Why Am I Bleeding After Menopause?

There are many potential causes of postmenopausal bleeding, including:

• Vaginal or endometrial atrophy: Your vaginal or uterine lining gets thinner due to the decreased estrogen levels that come with menopause
• Endometrial hyperplasia: Your uterine lining thickens due to increased estrogen levels (sometimes from hormone replacement therapy that some people undergo after reaching menopause)
• Polyps and/or fibroids: These two types of non-cancerous tissue can grow in your cervix or uterus
• Sexually transmitted infection (STI): Some STIs can cause bleeding, such as chlamydia, gonorrhea and herpes
• Uterine cancer
• Cervical cancer

How Will My Doctor Figure Out Why I’m Bleeding?

To determine the cause of your postmenopausal bleeding, your doctor will likely run one or more of the following tests:

• Pelvic exam: a physical examination of some of your reproductive organs to check for abnormalities
• Pelvic ultrasound: a technique that shows your doctor images of your reproductive organs
• Endometrial biopsy: a procedure where your doctor takes a sample of your endometrial tissue to check it for abnormalities
• Diagnostic hysteroscopy: a surgical procedure that allows your doctor to examine the lining of your uterus

Can I Stop My Postmenopausal Bleeding Naturally?

It is best to see with your doctor rather than try to figure out a way to stop the bleeding yourself. Your doctor will help you determine what’s causing your bleeding—and what the best route is to stop it.

Depending on the cause, your doctor may recommend one of the following treatments:

• For a vaginal or endometrial atrophy: 
  • Estrogen therapy via a vaginal cream or a pill
• For polyps and/or fibroids: 
  • Removal through surgery (dilation and curettage [D&C] or operative hysteroscopy)
• STIs:
  • Antibiotics
  • Antiviral pills
• Uterine cancer or cervical cancer: 
  • Radiation
  • Chemotherapy
  • Removal of the uterus and cervix through a hysterectomy surgery