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- When A Period Is *Very* Late (Post-Menopause)
When A Period Is *Very* Late (Post-Menopause)
Plus: 4 tricks for when doctors gaslight you
The 10almonds Team
January 07, 2024
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Today’s 30-Second Summary
If you don’t have time to read the whole email today, here are some key takeaways:
Postmenopausal bleeding and/or cramps can be a lot of things, from endometriosis to cancer to appendicitis.
Trying to figure out which via Dr. Google is a recipe for anxiety at the very best, so we recommend getting it checked in any case if you have either or both of these symptoms post-menopause
That said, there are some things it’s good to know about, and know to check for—including “is this cramps or appendicitis?” (see today’s main feature for more on this)
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Dr. Kaveh | 4 Tricks For When Doctors Gaslight You (13:49)
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😣 MAIN FEATURE
Knowledge Is Power Safety, Post-Menopause Too
Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.
If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).
PS: the appendicitis check near the end, works for anyone with an appendix 😉
We’ve talked before about things that come with (and continue after) menopause:
But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?
Bleeding
You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!
But it’s probably not.
Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.
So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:
Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.
The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.
Tip: Menopausal HRT will often correct this.
(“atrophic endometrium” and “endometrial atrophy” are the same thing)
In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.
Cramps
If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).
If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.
Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:
It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.
If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.
Special last note
Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.
And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.
Take care!
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📖 ONE-MINUTE BOOK REVIEW
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Wishing you a wonderful weekend,
The 10almonds Team