Bleeding and clots after menopause

Clots indicate that blood collected before leaving the body, but their size or appearance cannot reveal the cause. Arrange evaluation even if the flow settles.

Possible causes include thin vaginal or uterine tissues, polyps, thickening of the uterine lining, fibroids, infection, hormone treatment, and medicines that affect clotting. Cancer of the womb or cervix can present with postmenopausal bleeding, so visible clots should not be used to decide whether a cause is harmless or serious.

Bleeding may seem vaginal when it actually comes from the bladder, urinary tract, rectum, or nearby skin. Examination helps locate its source.

Contact a gynaecologist or primary care service promptly. Use pads so you can monitor the flow, and write down when it began, how often pads need changing, clot appearance, pain, discharge, bleeding after sex, and any urinary or bowel symptoms. Take your medicine list, particularly hormone therapy and blood-thinning medicines.

Assessment may include an examination of the vulva, vagina, and cervix, pelvic ultrasound, or sampling of the uterine lining. The choice depends on your history and findings. Do not stop prescribed treatment unless a clinician instructs you to do so.

Go to urgent or emergency care if the bleeding is heavy or increasing, pads are being soaked rapidly, or you develop fainting, significant dizziness, weakness, shortness of breath, chest discomfort, severe pelvic pain, fever, or confusion. Call emergency services rather than driving if you might faint.

A prompt clinic appointment remains necessary when the bleeding is light, occurs without pain, or has stopped, because those features do not identify its source.

Ask where the blood appears to originate, which causes fit the examination, and whether ultrasound or tissue sampling is advised. Clarify when results will be available, which symptoms require emergency help, and whether your hormone or blood-thinning medicine needs supervised adjustment.