Symptoms of bleeding after menopause

It may be noticed on toilet tissue, underwear or during sex. One brief episode still needs assessment, because the appearance and amount do not reveal the cause.

Tell the clinician about pelvic pain, pressure, vaginal dryness, pain during sex, unusual discharge, itching, urinary symptoms, bowel changes or a vaginal bulge. These details help guide the examination but cannot establish a diagnosis by themselves.

Possible sources include thin vaginal or womb-lining tissue, polyps, inflammation, infection and changes in the cervix or womb. Endometrial or cervical cancer may present with postmenopausal bleeding, which is why evaluation should not be delayed.

Arrange an appointment and write down the date, duration, colour and amount of each episode. Record any trigger, such as intercourse, and bring details of medicines, hormone products and previous gynaecological procedures.

Assessment may include questions about your history, a pelvic examination and tests chosen for the suspected source. These can include ultrasound, examination of the cervix or sampling of the womb lining. The clinician should explain what each test is for.

Get urgent care for heavy or ongoing blood loss, severe pelvic or abdominal pain, fainting, marked weakness or breathing difficulty. Prompt advice is also appropriate for fever, worsening pain or unpleasant-smelling discharge.

Light bleeding without other symptoms may not require emergency care, but it still calls for a clinical appointment even if it does not recur.

You might ask what the examination found, whether the bleeding source is clear, which further tests are needed, when to expect results and whom to contact if another episode happens before follow-up.