Bleeding After Menopause With Cramps

The bleeding may come from the vagina, cervix, womb, urinary tract, or rectum, so noting where you see it helps the clinician investigate.

After menopause, lower oestrogen can make vaginal and urinary tissues thin, dry, and easier to irritate. Polyps or thickening of the womb lining can also cause bleeding. Less commonly, bleeding is a presentation of cancer of the womb, cervix, or vagina; cramps do not identify the cause by themselves.

A clinician may perform a pelvic examination and arrange imaging or a sample of the womb lining, depending on your history and findings. Mention hormone therapy, tamoxifen, blood-thinning medicines, recent procedures, discharge, and any pelvic pressure.

Arrange a medical appointment promptly rather than waiting for another episode. Record when the bleeding began, its colour and amount, whether clots appeared, the pattern of cramps, and whether blood was noticed after urinating or opening your bowels.

Use a pad if you need to monitor flow. Avoid inserting vaginal products until the source is clearer, and bring a current medicine list to the appointment. Do not stop prescribed blood thinners without advice from the clinician who manages them.

Seek urgent medical care if bleeding is heavy or rapidly increasing, or if it occurs with severe or worsening pelvic pain, fainting, marked dizziness, weakness, breathlessness, fever, or feeling acutely unwell. These features need timely assessment regardless of the eventual diagnosis.

Ask which examination can locate the bleeding source, whether pelvic ultrasound or sampling of the womb lining is appropriate, how your medicines affect the plan, and whom to contact if bleeding returns before testing is complete.