Blood spotting is common during menopause; a 2014 study cited by WebMD shows that heavy menstrual bleeding is also normal during menopause. After a woman passes 12 months without having a menstrual period, she is considered to be in menopause; any bleeding that occurs later is postmenopausal, explains Healthline.
In a 2014 study of 1,300 menopausal women published in BJOG: An International Journal of Obstetrics and Gynaecology, 91 percent experienced bleeding for 10 or more days, 88 percent reported spotting for six or more days, and more than 75 percent had heavy bleeding for three or more days, according to WebMD. Women who undergo hormone replacement therapy during menopause may experience vaginal bleeding in the initial phase while their bodies adjust, states Healthline. Noncancerous polyps in the uterine lining can cause bleeding as does thickening of the endometrium. It is common for the vaginal tissue to thin in postmenopausal women due to decreased estrogen levels, which can result in bleeding.
In approximately 10 percent of women with postmenopausal bleeding, the underlying cause is endometrial cancer, notes Healthline. In noncancerous cases, estrogen creams may help prevent thinning of the vaginal tissue. Progestin is used to reduce bleeding caused by excessive endometrial tissue. Surgical removal of polyps is an option; the most invasive way to stop bleeding is through a hysterectomy.