Many women become very worried if vaginal bleeding occurs long after their periods have stopped. If the bleeding stops by itself, you might be tempted to postpone consulting your physician. If you use female hormones, bleeding may occasionally occur as a result. However, there may be other, more serious causes of bleeding even if you take these hormones. In all cases you should report any bleeding or any change in amount of bleeding or predictability to your doctor.

Sometimes the wall of the vagina becomes thin because of a lack of hormonal (estrogen) stimulation and causes bleeding, itching, or irritation. This is called senile vaginitis. Often a small amount of estrogen cream applied to the area relieves the symptoms. For those women already receiving cyclical hormone therapy this is usually not necessary. Prevention of and treatment of senile vaginitis decreases the pain that might be associated with intercourse during the later years.

An important cause of bleeding is the presence of tumors, either benign or malignant. Unless the cause is obvious from a gynecological examination, many physicians will recommend a dilatation and curettage (D and C) to diagnose the cause and ensure that no tumors are present. The D and C consists of widening the entrance to the cervix while you are anesthetized and “scraping” the lining of the uterus to obtain tissue for analysis. With this procedure the cause of the bleeding can usually be identified and proper treatment recommended.

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