In most cases, however, the cause is unknown. Girls with vaginal adenosis have an increased risk of developing cancer of the vagina and cervix later in life. Cancer may cause bleeding in this age group, but not commonly. The most serious cause of bleeding from the vagina after menopause is cancer, such as cancer of the uterine lining, the cervix, or the vagina. The symptoms and a physical examination help a doctor determine what other procedures are needed for diagnosis.
Treatment varies, depending on the cause.
If a doctor suspects vaginal adenosis or cancer in a girl, a sample of cells is removed from the vagina and examined under a microscope. A woman who has abnormal bleeding from the vagina, particularly after menopause, is examined to determine whether she has cancer. Uterine polyps, fibroids, and cancers may be surgically removed. A postmenopausal woman who has irregular bleeding while taking estrogen may have more regular menstrual periods if a progestin is also taken for about 10 days of each cycle. If a woman doesn't take a progestin with estrogen, she has an increased risk of developing cancer of the uterine lining.