Brown discharge after menopause

Many causes are not cancer, but colour and amount cannot identify the source. Prompt assessment allows treatable causes to be found and serious causes to be excluded.

After menopause, lower oestrogen can make vaginal or cervical tissue thinner, drier and more easily irritated. Light bleeding from this tissue may mix with discharge and turn brown. Polyps, infection, medicines that affect bleeding, changes in the womb lining, and cancers of the reproductive tract are other possible explanations.

Bleeding is considered postmenopausal when it occurs after periods have stopped because of menopause. If you use menopausal hormone therapy, unscheduled bleeding may relate to the regimen, but it still needs advice according to its timing and pattern.

Book a medical appointment rather than waiting for another episode. Record when the discharge appeared, its amount, whether there was fresh blood, and any pelvic pain, itching, odour, urinary symptoms or bleeding after sex. Bring a list of medicines and details of any hormone therapy.

Assessment may involve looking at the vulva, vagina and cervix, followed by imaging or a sample from the womb lining when indicated. The clinician chooses tests from your history and examination; having an assessment does not mean a serious cause has already been found.

Seek urgent care if bleeding becomes heavy, you feel faint or markedly weak, or you develop severe pelvic or abdominal pain. Fever with worsening pain or foul-smelling discharge also warrants prompt medical attention because infection may need treatment.

Without urgent symptoms, contact a gynaecology or primary care service soon. Do not delay because the discharge stopped or because it was brown rather than red.

Ask where the discharge appears to originate, which tests are suitable, how and when results will be shared, and what changes require urgent review. If you use hormone therapy or blood-thinning medicine, ask whether it could influence the bleeding and continue it unless your prescriber advises a change.