Bleeding After Menopause

Common explanations include thinning and dryness of vaginal or womb-lining tissue, polyps, and effects of hormone medicines. Less commonly, abnormal changes in the womb lining or another gynaecological condition may be responsible, so evaluation should not be delayed.

Postmenopausal bleeding includes fresh blood, pink or brown staining, and blood-tinged discharge after periods have ended because of menopause. It may appear on underwear, toilet paper, or after sex. A small amount still counts.

Blood can originate from the vagina, cervix, or womb, and urinary or bowel bleeding can sometimes be mistaken for vaginal bleeding. Vaginal dryness may make tissue vulnerable to contact bleeding, but symptoms alone cannot confirm the source.

Contact a gynaecology or primary care service promptly and say that the bleeding occurred after menopause. Note the date, amount, colour, whether it followed sex, and any pain or discharge. Bring a list of medicines, including hormone therapy and blood-thinning medicines.

Assessment may include an examination of the vagina and cervix, ultrasound imaging, or sampling of the womb lining. The clinician selects tests based on your history and findings; these checks identify the bleeding site and guide treatment.

Seek emergency help if bleeding is heavy or comes with fainting, severe dizziness, breathlessness, chest discomfort, confusion, or marked weakness. Severe new abdominal or pelvic pain also needs urgent assessment.

If none of those warning signs is present, the episode still needs prompt medical review. Do not wait to see whether it returns, and do not assume vaginal dryness or hormone treatment is the cause without assessment.

Ask where the blood seems to have come from, which examination or scan is recommended, and whether the womb lining needs sampling. Also ask how current medicines affect bleeding and whom to contact if another episode occurs before testing is complete.