Brown spotting after menopause

A small stain or brown discharge still counts because the colour may simply indicate older blood. Book an assessment rather than waiting to see whether another episode occurs.

After menopause, vaginal and cervical tissues may become thinner, drier and easier to irritate. Polyps, inflammation and changes in the womb lining can also cause bleeding. Less commonly, postmenopausal bleeding is a presentation of cancer of the womb or cervix, which is why examination matters.

Bleeding may come from the vagina, cervix or uterus, while blood from the urinary or digestive tract can sometimes be mistaken for vaginal spotting. A clinician can help identify the source.

Contact a gynaecologist or primary-care clinician promptly. Before the visit, note when the spotting started, its amount, whether it followed sex and whether you have pelvic discomfort, vaginal dryness or unusual discharge. Bring a list of medicines, including hormone treatment and blood-thinning medication.

Assessment may include questions about the bleeding, an examination of the vagina and cervix, and tests to examine the womb lining. The exact approach depends on your symptoms, medical history and examination findings.

Routine spotting after menopause still warrants prompt clinical review. Seek emergency care if bleeding becomes heavy or accompanies severe or increasing pelvic pain, fainting, pronounced dizziness, shortness of breath, confusion or a feeling that you are becoming acutely unwell.

You might ask where the blood appears to be coming from, which examination or imaging is recommended, whether a sample of the womb lining is needed and how you will receive results. Mention any vaginal products or hormone medicines so their possible effects can be considered.