Abby Normal Bleeding

Concerns of seeing blood postmenopause

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Are you familiar with the reference that “Abby Normal” comes from? A funny movie I saw as a teen was the 1974 film by Mel Brooks, Young Frankenstein, starring Gene Wilder, Marty Feldman, Peter Boyle, and a bunch of other top-talent comedians.

In one scene, Gene Wilder as Dr. Frankenstein asks his assistant, Marty Feldman, where he got the brain he used to create Frankenstein. His assistant tells him that he got it from a container labeled “Abby someone,” and then explains it was “Abby Normal.” Dr. Frankenstein realizes that he just put the abnormal brain into Frankenstein instead of the one he wanted to use. I’ve included the clip below at the bottom.

It’s a fun reference to guide us through today’s topic. This article focuses on what happens when vaginal bleeding shows up when it’s not supposed to, which is in postmenopause. You can also have visible blood in your stool and blood in your urine (from your urinary system, not from vagina), but this article stays true to the vaginal area.

What is Postmenopause?

Perimenopause is the 2 - 14 years before reaching menopause.

Menopause is one day, the 365th day after your last period (or via surgery to remove your ovaries, or chemically via medicine).

Once you’ve gone 366 days without a period, you’re in the “postmenopause” stage of your reproductive life. This means that your ovaries no longer ovulate and release ovarian hormones, estradiol estrogen, progesterone, and some testosterone. At this point, your periods are officially O.V.E.R!

There are some instances where using your period to help you determine if you’re postmenopausal (which is commonly referred to as “being in menopause” or “menopausal’) is impossible such as in the case of a uterine ablation (you’ll know if you’ve had one), being on birth control pills, or having your uterus removed but not your ovaries.

What is Abby Normal Bleeding?

The lecture I attended was with Dr. Steven Goldstein, MD, MSCP, FACOG, professor, Department of Obstetrics and Gynecology at NYU Grossman School of Medicine, who is a national expert on the diagnosis and treatment of abnormal bleeding.

The information contained in this article is a summary appropriate for the general population and does not constitute medical advice. References are listed below. ¹²

Here’s the short answer for what is abnormal bleeding:

Any vaginal bleeding that shows up postmenopause is considered abnormal bleeding.

“Any vaginal bleeding” means staining, bleeding, or brown discharge, regardless of whether it’s a drop or a lot, or happens once or several times.

Why Talk About This Now?

My articles focus on perimenopause, so I assume a large number of my readers (You! Thank you very much!) are currently in perimenopause. You may be years away from menopause, so why talk about this now?

This information is important for perimenopause and postmenopause because it’s important information 👀.

Dr. Goldstein mentioned a study he conducted in which 37% of participants did not know that bleeding postmenopause is a cause for concern because it’s a symptom of endometrial cancer.³ This is one of those markers you want to know what to do beforehand in case it happens to you.

Say What!? Did You Say the C Word?

Endometrial cancer is uterine (uterus) cancer. According to Dr. Goldstein, the likelihood of abnormal bleeding being caused by endometrial cancer is up to 14% postmenopause.⁴

Doctors are taught to take bleeding postmenopause very seriously to evaluate for the presence of cancer, which means a full assessment of the cause of the bleeding is needed. A large part of the lecture included training physicians and clinicians on how to evaluate abnormal bleeding and the recommended treatment options. These are the times I’m grateful I’m not a physician because I don’t know how they keep everything straight, but I love to listen in.

Just because your doctor is going to take this seriously doesn’t mean it’s time to jump to worst-case-scenario conclusions. There are other reasons that can cause abnormal bleeding postmenopause, and these will be determined at your appointment or follow-up appointments. Some examples include vaginal dryness (which can cause tears and bleeding), polyps, fibriods, hyperplasia overgrowth of the uterus lining, physicial trauma, prolapse, and a condition called adenomyosis.

There are some factors that cause an increased risk of endometrial cancer and include “increasing age, obesity, diabetes mellitus, low parity⁵, polycystic ovary syndrome⁶, family history of endometrial cancer, a personal mismatch repair gene mutation (Lynch syndrome), and unopposed estrogen therapy⁷.”

If this quote is confusing, I added some footnotes below.

If You See Blood Vaginally Following Menopause

A major concern for women is whether they are overreacting before calling their doctor. I’ve been there, too. Sometimes, it’s hard to evaluate what warrants a phone call. Many times, we may be tempted to take a wait-and-see approach.

The best thing we can do if we see blood vaginally postmenopause is to call your doctor or healthcare practitioner.

Just like all bleeding should be evaluated during pregnancy, the same holds true during postmenopause. See something, say something.

Young Frankenstein Clip

If you need help figuring out where you are in the perimenopause to menopause to postmenopause process, I wrote The Musical Dynamics of Perimenopause. Or, we can walk through this together on a 1:1 appointment.

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Be well, stay cool…

Shelby Tutty, MHA
Certified Perimenopause Educator
Founder of The Periprofessional, LLC

Disclaimer, Content Use Policy, Privacy Policy

1. Goldstein, Steven MD, MSCP, FACOG. Evaluation of postmenopausal bleeding. Menopause 32(3):p 275-277, March 2025. | DOI: 10.1097/GME.0000000000002522

2. The Menopause Society. The Menopause Guidebook, 10th Edition. 2024

3. Goldstein, Steven MD, MSCP, FACOG. Evaluation of postmenopausal bleeding. Menopause 32(3):p 275-277, March 2025. | DOI: 10.1097/GME.0000000000002522

4. Goldstein, Steven MD, MSCP, FACOG. Evaluation of postmenopausal bleeding. Menopause 32(3):p 275-277, March 2025. | DOI: 10.1097/GME.0000000000002522

5. Low parity is defined as having given birth to 2 or fewer live infants according to the World Health Organization. Some others define it as 1 or fewer. This article and lecture did not specify which applied here.

6. Known commonly as PCOS.

7. Means prescribing estrogen without progesterone when a woman has a uterus.