Gynecology / Women's Health Expert Forum
post-menopausal spotting
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post-menopausal spotting

I am ten years post-menopausal. A few weeks ago, I noted pinkish spotting on the toilet paper. I am generally careful to watch for such events whether vaginal, rectal or from the urethra.  This happened one time only that I noticed either prior or after, and I believe I would have noticed. I had my regular annual exam coming up so I discussed with my gyn. She has set up an ultrasound for later this month. After my pelvic exam I had a little spotting, but only for a day.The only prior incident like this was a number of years ago and she said it was just the delicate and thin tissue one gets as one ages.  I'm hoping that is the case this time.  I don't know what you can tell me, but I guess I need some reassurance or another opinion though I know possibilities, so guess I have to just wait and see the results of my pap smear and the ultrasound. I did have a polyp in the past and my gyn performed a colposcopy to discover it and removed it. I'm just a little panicked as I know post-menopausal women should not have spotting.  
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Hello,

Postmenopausal bleeding is always concerning and deserves an evaluation.  Causes of postmenopausal bleeding include endometrial polyp(s), endometrial hyperplasia (overgrowth of normal tissue) or endomterial cancer; additionally, sometimes women can have bleeding from atrophy (a too thin endometrial lining).  

The evaluation for this typically involves a physical exam, a pelvic ultrasound and an endometrial biopsy (sampling of the tissue inside the uterus to assess for hyperplasia or cancer), and when the biopsy is benign (ie, not hyperplasia or cancer) and the endometrial lining is thick, evaluating the inside of the uterus by hysteroscopy or sonohysterogram for a polyp.  


Best regards,

Dr. Downing
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