What to Know About Prolapse Bleeding After Menopause

Uterine prolapse is when your uterus starts slipping down from its usual place in your pelvis.

It’s a common condition to experience once you’ve been through menopause.

So if you’re postmenopausal and notice any vaginal bleeding or spotting, prolapse bleeding after menopause could be the culprit.

The best thing to do in that situation is to make an appointment with your doctor so you can discuss your symptoms and they can examine you.

That’s because there are a number of other conditions that can also cause vaginal bleeding after menopause, and it’s important to get a diagnosis ASAP so you can start the right treatment.

Let’s find out more.

In this article: 📝

What is uterine prolapse?

Normally, the uterus is held in place in your pelvis by your pelvic muscles and ligaments.

But if these muscles and ligaments get stretched or become weaker, they can start to struggle to keep your uterus where it’s supposed to be.

This is what leads to uterine prolapse — where the uterus begins slipping down from its usual position and into your vagina.

What causes a uterine prolapse?

The condition is especially common in women who’ve gone through menopause, partly due to the natural aging process and partly because of reduced estrogen levels.

But there are other factors that can increase your risk of prolapse, too, including:

• Having had a vaginal birth
  
• Obesity
  
• A long-lasting, severe cough
  
• Long-lasting, severe constipation

Essentially, anything that puts extra strain on your pelvic floor muscles over a long period can make prolapse more likely.

The condition isn’t dangerous, but it can cause symptoms that impact your quality of life.

Can a prolapse cause bleeding after menopause?

Yes, it’s possible.

Many women experience minor prolapse (where the uterus slips just a little), which may not cause any symptoms at all.

But moderate to severe prolapse can lead to symptoms such as:

• Vaginal bleeding
  
• Discomfort while having sex
  
• A dragging or heavy feeling in your pelvis
  
• A sensation like sitting on a ball
  
• Your uterus and/or cervix poking out of your vagina
  
• Problems with your bladder and bowels, such as constipation, bladder infections, and incontinence

When should you see a doctor about prolapse bleeding after menopause?

If you have any kind of postmenopausal spotting or bleeding, it’s best to check in with your doctor ASAP.

As you don’t get your period anymore after menopause (in fact, that’s the definition of menopause!), vaginal bleeding is likely caused by something else.

So it’s important to get to the bottom of it.

(We’ll talk more about other potential causes of bleeding after menopause below.)

To diagnose uterine prolapse, your doctor will assess your symptoms and perform a pelvic exam.

The exam can be done while you’re lying down or standing up, and your doctor might ask you to bear down as if you were having a poo to help them see how severe the prolapse is.

How to fix uterine prolapse?

The good news is there are a few different treatments out there that can help manage a prolapse, ease your symptoms, or even reverse the prolapse completely.

These include:

Lifestyle changes

Anything that reduces the pressure on your pelvic floor or strengthens the muscles there may help with prolapse, including:

• Doing regular pelvic floor exercises
  
• Losing weight
  
• Avoiding any heavy lifting

Nonsurgical treatments

You can try a vaginal pessary.

This is a rubber or silicone device that fits beneath your cervix and helps support the walls of the vagina and keep the pelvic organs in place.

Or, for mild prolapse after menopause, estrogen treatment can be used to help ease symptoms such as vaginal dryness and discomfort during sex.

This is usually in the form of a cream, tablet, or ring that’s inserted into your vagina.

Surgery

For more severe prolapse, there’s various types of surgery can be used to repair or strengthen the muscles and ligaments in your pelvis.

Or you could consider a hysterectomy (an operation to remove your uterus).

Your doctor will talk you through the different options so you can decide which treatments would work best for you.

What causes postmenopausal bleeding?

If a prolapse isn’t responsible, here are some other common causes:

Genitourinary syndrome of menopause

(Also known as “vaginal atrophy,” but we’re not keen on that term as it doesn’t encompass the full condition, nor does it link it to menopause.)

It’s where the vaginal walls become thinner and dryer, which can cause bleeding after sex.

A topical estrogen cream and extra lubrication during sex may help.

Uterine polyps or fibroids

These are noncancerous growths in the uterus that might need to be removed with surgery.

Endometritis

This is where the lining of the uterus gets infected, but the condition is usually treatable with antibiotics.

Endometrial hyperplasia

This means that the lining of the uterus has become too thick. Progestin therapy tends to be the way forward here.

Some medications

Blood thinners and hormone therapy can both cause postmenopausal bleeding.

Certain cancers, including uterine, cervical, and ovarian cancer, can also cause vaginal bleeding after menopause.

We know this might sound worrying, but getting an early diagnosis gives you the best chance of receiving the right treatment when you need it and making a full recovery.

So don’t dismiss bleeding or spotting as just something you have to live with.

Give your doctor a call and go for a check-up.

Should I go to ER for bleeding after menopause?

It’s definitely important to see your doctor as soon as you can if you’re experiencing bleeding after menopause.

The ER is usually reserved for conditions that could be life-threatening without emergency treatment (see this list).

If in doubt, call your doctor’s office, describe your symptoms, and ask for advice on what your next steps should be.

Uterine prolapse after menopause, whether or not bleeding is one of your symptoms, can really impact your quality of life—but it’s not something you just have to live with.

Chat with your doctor about which treatment options could help.

You might also want to check out the Pelvic Prolapse Support Group on Peanut.

Or, for conversations about all things menopause, join our Peanut Menopause community.

You don’t have to do this alone.