Why Do Some Women Still Menstruate After Menopause?

Why do some women menstruate after menopause?

Let’s talk about it.  

You would think once you reach menopause, you would stop having periods but not all women do.

These aren’t traditional periods where you’re ovulating. They’re more breakthrough bleeding.

Not Enough Progesterone

The number one reason that women still menstruate after menopause, is that they don’t have enough native progesterone on board or they’re not taking enough bioidentical progesterone to counterbalance estrogen. 

Too Much Estrogen

Number two, they have too much estrogen on board from hormone replacement therapy.

With inadequate levels of progesterone, estrogen stimulates the endometrial lining causing breakthrough bleeding. Progesterone helps to stabilize the lining. 

Without adequate progesterone to counterbalance estrogen, menopausal breakthrough bleeding is common. 

Hormone Replacement Therapy Can Induce Menstruation

Number three is menopausal women may be cycling their hormone replacement therapy to induce menstruation.

If you give enough hormones to even an 80 year old woman, you can actually stimulate her uterine lining to proliferate and then to bleed when she withdraws from those hormones.

Endometrial Hyperplasia 

Number four, she may have endometrial hyperplasia.

In this case, the endometrium is built up to the point of being precancerous. A pelvic ultrasound is important to measure the endometrial lining and an endometrial biopsy may be necessary to be sure that the endometrium is not cancerous.

For a thickened endometrial lining, a medicinal or surgical D&C can slough off the proliferative lining. Then make sure that the hormones are well balanced to prevent endometrial build-up. 

Not Getting Enough Estrogen

Number five, you’re not getting enough estrogen. Low levels of estrogen can cause a friable endometrium which bleeds after being jostled by intercourse or even exercise.

A pelvic ultrasound can help determine if your endometrial lining is within normal limits for menopause. 

If you have questions, please join us in our Hormone Reboot Training.