Vaginal bleeding after menopause abnormal – Gynaecologist

On Oct 4, 2023

A maternal health expert, Dr. Modupe Adedeji, the Consultant Gynaecologist and Obstetrician at the Lagos State University Teaching Hospital, Ikeja, said it is not normal for a woman to be bleeding after menopause, advising women experiencing such to seek help.

According to her, any bleeding experienced at post-menopause should be investigated and not be mistaken for menstrual irregularities.

The gynaecologist, who spoke during an interview with newsmen revealed that as simple as some contraceptive medications could be, they can cause menstrual irregularities.

“Women should never expect bleeding per vaginam of any kind after menopause. Any bleeding experienced during this period must be investigated. It doesn’t mean that menses have resumed again. The factor to always rule out when such happens are cancers of the reproductive system.”

Speaking on menstrual irregularities and the factors responsible, the maternal health expert said, “Menstrual irregularities is one of the common gynaecological complaints in our clinics. Is obviously related to the female reproductive system, which is regulated by the central nervous system. To know probable cause depends on some factors like age and the characteristics of the menstrual irregularities (menorrhagia- excessively and prolonged menstrual flow, scanty menstrual flow, intermenstrual bleeding, delayed menses, cessation of menses). Others are any surgical procedure done and medications used. Menstrual irregularities just after menarche (commencement of menstruation) may physiology for a few years before is regulated because of the maturity of the central nervous system. The reasons could be due to the effect of anovulation – (follicles/eggs refuse to get out from the ovary), excessive weight gain or weight loss, and extreme exercise like in athletes.

“Also, during the core reproductive age, issues like polycystic ovarian syndrome, polyps, fibroid, synechiae and soon could be gynaecological reasons. As simple as some contraceptive medication can have the effect of menstrual irregularities”, she explained.

According to her, towards the end of the reproductive age, perimenopausal period when the follicles are already exhausted, women notice irregularities with their menstruation.
She stated that at this period, the frequency of the menstrual flow becomes few (climacteric period) and even scanty in volume before it eventually stops.

In a study published in the Journal of Islamabad Medical & Dental College, which examined the pattern of menstrual Irregularities amongst women, the researchers found that most patients are unaware of what represents a normal menstrual pattern. According to them, it is important to educate patients regarding the range of normal cycle length.

“It is equally important for clinicians to have an understanding of bleeding patterns and ability to differentiate between normal and abnormal conditions. The menstrual cycle as an additional vital sign adds a powerful tool for the assessment of normal development and exclusion of pathological conditions. Menstrual dysfunction also results in both infertility and increased future risk of various diseases like diabetes and cardiovascular diseases”, the researchers said.

PUNCH/Wumi