Abnormal uterine bleeding around menopause

Postmenopausal bleeding includes light spotting, pink or brown discharge, and bleeding that happens only once. It should be reported even if there is no pain or the bleeding stops.

During perimenopause, ovulation becomes less predictable, so cycles may shorten, lengthen, skip, or vary in flow. Hormone therapy, contraception, medicines that affect clotting, fibroids, polyps, and thyroid or bleeding disorders can also alter the pattern.

After menopause, bleeding may come from fragile vaginal or cervical tissue, polyps, thickening of the uterine lining, infection, or cancer. Womb cancer commonly presents with postmenopausal bleeding, but bleeding has other possible explanations; examination and testing determine the cause.

Contact a healthcare professional promptly after any postmenopausal bleeding. For bleeding during perimenopause, arrange review when it is very heavy, occurs between periods or after sex, lasts longer than your normal flow, or represents a persistent change.

Write down the dates, amount, colour, clots, pain, and possible triggers. Bring a list of hormone treatments, supplements, and medicines. Assessment may include pelvic examination, blood tests, transvaginal ultrasound, and a sample from the uterine lining based on clinical findings.

Go to urgent care if bleeding becomes heavy and you feel faint, weak, short of breath, confused, or have chest discomfort. Severe pelvic or abdominal pain with bleeding also needs urgent evaluation.

Fever, offensive discharge, or worsening pelvic pain should prompt same-day medical advice because infection is possible. If you are not sure whether your periods had fully stopped, describe the interval and pattern to the clinician rather than deciding that the bleeding is normal.

Ask which part of the reproductive tract appears to be bleeding, whether your medicines or hormone treatment could contribute, and which tests are planned. Clarify how a uterine-lining sample is taken, when results will arrive, and what follow-up is needed if bleeding returns.