Medical experts have sounded a clear warning to women, stressing that any bleeding after menopause should never be ignored, as it may signal life-threatening conditions, including cancer.
Gynaecologists who spoke with Observers Times explained that while some women dismiss post-menopausal bleeding as a harmless sign of ageing, it is in fact a red flag that requires urgent medical attention.
Professor Chris Aimakhu, the second Vice-President of the Society of Gynaecology and Obstetrics of Nigeria, stated that menopause, which typically occurs between the ages of 48 and 54 in Nigeria, marks the permanent end of menstruation.
“Bleeding is not supposed to happen after menopause,” he said. “Before the bleeding finally stops, there is usually what is called a transition period, when a woman experiences symptoms suggesting that menopause is approaching. But once menopause sets in, menstruation should stop completely. It is not normal to bleed 12 months or more after the last menstrual period.”
Aimakhu, who is a Professor of Obstetrics and Gynaecology at the University of Ibadan, explained that while infections, fibroids, and even medications may cause abnormal bleeding, the most serious culprits are cancers of the cervix, womb, ovaries, and vagina.
“The most serious causes are cancers, including vaginal cancer, cervical cancer, cancer of the womb, and ovarian cancer. Foreign bodies inside the vagina, such as sex toys, can also cause bleeding,” he warned.
According to him, many women only present at hospitals when their cancer has spread beyond treatment by surgery, leaving radiotherapy as the last option.
“It can be very dangerous. Some cancers, especially cervical cancer, which is the most common genital cancer among women, first present with postmenopausal bleeding. Unfortunately, many women ignore the symptoms until the cancer has advanced and spread, making surgery impossible,” he said.
Corroborating this, Consultant Gynaecologist Dr. Ayodele Ademola stressed that no bleeding outside menstruation is normal.
“We must note that the only normal bleeding that women have is menstruation, which is periodic. Every other source of blood from the body is a red flag,” he said. “Now, coming back to menopause, we must also acknowledge that there are a few occasions when the ageing effect on the body due to menopause can actually cause a woman to bleed. But even at that, it is not normal. Nobody should consider it normal.”
Ademola, however, reassured women that not every case of postmenopausal bleeding is cancerous. “Whichever the case, all postmenopausal bleeding is considered dangerous until proven otherwise. I emphasize the word ‘otherwise’ because it is not 100% of cases that turn out to be cancer. But the majority are usually due to one form of cancer or another,” he said.
