Menopause & Spotting


Bleeding at any time outside of a normal menstrual cycle can really be quite unnerving. There are many causes for spotting during menopause, many of which are benign, but it's important to remember that even though bleeding occurs during menopause, all instances of bleeding are considered abnormal, until investigated.

Uterine Causes

  • During menopause, levels of the hormone responsible for menstruation, estrogen, is significantly decreased, which causes the ovaries to stop producing eggs. The decline in estrogen may also cause the uterine walls to become thin, causing atrophy. This happens when the blood vessels housed in the walls, become weak and burst spontaneously. This may cause a bit of brown, pink or red spotting. Other causes for uterine bleeding include uterine polyps, too much thickening of the lining and uterine fibroids.

Vaginal Causes

  • The most common form of vaginal bleeding is cause by vaginal dryness, which causes vaginal atrophy. Much the same as uterine atrophy, vaginal atrophy causes bleeding due to a thinning of the vaginal lining. This bleeding is usually brought on by sexual intercourse and may be accompanied with itching, stinging or burning pain.

Ovarian Causes

  • The imbalance of the hormones estrogen and progesterone caused by menopause may result in the formation of ovarian cysts. These are benign growths that form in follicles of the ovaries. The signs of ovarian cysts are pain during bowel movements, distended abdomen, irregular bleeding (spotting or heavy) and lower abdominal cramps or pain.

Medication Side-Effects

  • Some women take replacement estrogen (hormone-replacement thereapy, HRT) to relieve symptoms of menopause, such as hot flashes and night sweats. Using HRT, however, may cause uterine bleeding, due to too much buildup of the uterine lining, triggered by replacing the estrogen.


  • Bleeding during the early stage of menopase (perimenopause) is actually quite normal, since you still have a menstrual period. Due to the gradual decrease of the hormone estrogen, the menstrual cycles may become irregular, and also cause spotting between periods.


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