What could be the cause of vaginal bleeding in a 53-year-old woman who has been postmenopausal for three years?

Generally, vaginal bleeding occurring three years after menopause in a 53-year-old woman is usually caused by adverse stimuli, intrauterine device (IUD) effects, atrophic vaginitis, cervical polyps, coagulation disorders, or other factors. If discomfort occurs, timely medical consultation is recommended. Detailed analysis is as follows:

1. Adverse Stimuli

External stimuli such as intense physical activity may cause minor injuries to the vagina or uterus, leading to bleeding. It is advisable to engage in moderate exercise and discontinue any activities that may cause irritation. Opt for gentle exercises such as walking or meditation.

2. Intrauterine Device (IUD) Effects

If a woman has an IUD, abnormal positioning or embedding of the device may lead to postmenopausal bleeding, possibly accompanied by symptoms like abdominal pain. Prompt medical evaluation is recommended, and the IUD should be removed under a doctor's guidance.

3. Atrophic Vaginitis

After menopause, significantly reduced estrogen levels cause the vaginal mucosa to gradually atrophy and thin, making it prone to infection or injury, which may result in light bleeding. Women are advised to follow medical instructions and use medications such as clotrimazole vaginal tablets, ofloxacin suppositories, or metronidazole tablets for treatment.

4. Cervical Polyps

Infection with pathogens such as bacteria or viruses may trigger the formation of cervical polyps. Minor irritation of the polyp can cause blood vessels to rupture, resulting in postmenopausal vaginal bleeding, which may be accompanied by increased vaginal discharge. Maintaining good hygiene practices is important. Additionally, under medical guidance, medications such as amoxicillin capsules, cefdinir dispersible tablets, or Gynecological Qianjin tablets may be used for treatment.

5. Coagulation Disorders

Coagulation disorders may arise from genetic factors, disrupting the blood clotting process and leading to vaginal bleeding. This condition may be accompanied by systemic symptoms such as anemia or fever. Patients should seek care at specialized medical facilities and receive intravenous treatments such as human prothrombin complex concentrate, vitamin K1 injection, or recombinant human factor VIII under physician supervision.

Maintaining good personal hygiene, avoiding strenuous exercise, adopting a healthy lifestyle, and undergoing regular gynecological examinations are recommended in daily life.