Spotting Following Cortisone Injection

I had a cortisone injection to my hip about 4 years ago. I was 9 years post menopause at the time and on hormone replacement therapy. I developed vaginal bleeding about 2 days later that lasted about 5 or 6 days. I had an endometrial biopsy which was negative for cancer. I have not had any post menopausal bleeding apart from that one time so can only conclude it was related to the cortisone injection, although my gynecologist wasn't aware of that as a side effect.

I am 66 postmenopausal for 12 years. I have now had 2 episodes of post knee injection bleeding 10-12 days after Kenalog(triamcinolone acetonide) injections on my knee (11-28-22 and 3-16-23). I had a D&C in May of 2022 and follow up Ultra sounds and PAPs in Oct. of 2022. I saw my Gynecologist after the first episode and was told this is not uncommon, but we will watch to see if anything else develops. I was surprised when it happened the second time. I have had other injections in my back with a different steroid with no bleeding. Unfortunately the Orthopedics' office only uses Kenalog for knee injections. So I am left to find a different route for knee pain. Which is unfortunate because the Kenalog worked well. They have suggested Hyaluronic Acid injections. I hope this post helps

Same. Received Kenalog injections twice. Both times had post menopausal bleeding that started 2 weeks after the injection. I went through menopause 12 years ago. My dr has ordered an ultrasound which will be done asap!

Hi, @rach3455 - welcome to Mayo Clinic Connect. Did your doctor have any input on a connection between the injections and your postmenopausal bleeding? Do you have a scheduled date now for your ultrasound?

@junglehood - Have you continued to have bleeding? Did you have your ultrasound? If so, did they find anything?

Hi, @rach3455 - welcome to Mayo Clinic Connect. Did your doctor have any input on a connection between the injections and your postmenopausal bleeding? Do you have a scheduled date now for your ultrasound?

@junglehood - Have you continued to have bleeding? Did you have your ultrasound? If so, did they find anything?

My primary doctor had never heard of this and doubted the bleeding was due to the steroid injection. (?).
The orthopedic had never heard of this as a side effect, which left me wondering. I googled about it when it first happened and found the information myself. I then reported it to both of my doctors.

@rach3455 - great that you are doing research on your own. So you presented the potential connection between the injections and bleeding to your doctors? Is ultrasound the next step?

@junglehood - with a clear ultrasound, what was your doctor's diagnosis for your bleeding situation? Are you saying your bleeding is mostly spotting, versus a heavy flow?

Wow, I am glad I found this. Thank you all for sharing your experiences.
I am 60 years old in June of 24 and post menopause for 8 years. Never had any spotting. I am very active and fairly fit woman.
I had an epidural steroid shot for sacroiliac joint paint March of 2024. The shot gave me great relief from almost 3 years of pain. In about 4 weeks later I started having a heavy period with cramping. I had a full work up with mri, ultrasound, vaginal ultrasound and a second exam at the gyno. I do have an ovarian cyst and 3 small uterine fibroids. I am on low dose hrt for over 2 years. No bleeding on that ever.
My gyno did say that steroids can cause some post bleeding. My bleeding went from the end of April 24 until the last bleeding in September of 24. This was mostly every 2 weeks and finally the last 2 were 1 a month.
I am scheduled for a hysterectomy soon because this was such a discomfort and annoyance.
I think now it may have stopped but I still feel the cramping off and on.
I may need to have another injection at some point for the SI joint problem and do not want to experience this bleeding again.
I hope this is the right thing to do.