In studying the female genitalia and reproductive system, it brought to mind my curiosity of why elderly women have vaginal bleeding. A woman’s reproductive system changes after menopause due to decreased levels of estrogen and lack of sexual activity. However, I have found that women who have continued sexual activity do not show these changes as much. Most older women do not seek regular gynecological care, because they feel they are past worrying about their reproductive systems. They become embarrassed about their body changes. The usual menopausal age is around 51 years of age. Hot flashes are the most common problems reported. Other postmenopausal signs and symptoms include vaginal dryness, thinning, and bleeding. Menopause symptoms last longer than 5 years in 25% of women and continue throughout life in a small percent of women. Some women seek estrogen replacement therapy to relieve these problems. However, estrogen replacement therapy has side effects which include risks of breast cancer, uterine cancer, stroke, and deep vein thrombosis. Most women do not want to take these risk. Disorders of the vulva, labia and surrounding skin become more common as women age. Most reported problems are irritation, inflammation, and infection. Inflammation and irritation can develop from allergic reactions, as well as fungal, yeast, and bacterial infections. Burning, pain, or bleeding should be further evaluated. Vulvar cancer can becomes more common with age. Half of these cases occur in women over 70 years of age. The lining of the vagina commonly thins, pales, and becomes less elastic or flexible in postmenopausal women. Estrogen deficiency after menopause causes the lining of the vagina and urethra to weaken. Common symptoms include vaginal dryness, inflammation, discharge, burning, bleeding and pain.
A number of older women have postmenopausal bleeding. Vaginal bleeding has several possible causes such as inflammation, ulceration, thinning, or cancer of the vulva and vagina. Cervical irritation, infection, cancer or polyps, can cause bleeding. Uterine problems causing bleeding can be from thickening of uterine lining, thinning of uterine lining, swelling of glands in uterine lining, polyps or tumors. Urinary tract infections irritation, tumors (benign or malignant), and stones can cause bleeding. Hormone replacement therapy, or problems, bleeding disorders, being on blood thinners, these can also cause bleeding.
A woman should seek a complete physical exam with a biopsy of the uterus, pap smear, ultrasound, and any other test that may me needed to find the source of the bleeding disorder. A doctor would be able to give the best medical advice on any type of bleeding disorders once the source has been found and diagnosed.
Reference: http://www.healthimaging.orrg/aging in the know/chapters_ch_trial.asp?ch=49
Also, referred to the text book:Health Assessment for Nursing, 3rd Ed, Wilson & Giddens copyright 2005, Chapter 21, pgs 493-494