Causes of bleeding after menopause

Genitourinary syndrome of menopause can make vaginal or urinary tissues dry and fragile, leading to spotting, particularly after sex. Endometrial polyps and endometrial hyperplasia can also cause bleeding. Womb, cervical, and vaginal cancers may present this way, which is why the symptom should be investigated rather than watched indefinitely.

Any pink, red, or brown vaginal spotting after periods have stopped because of menopause counts, even if it occurs once or only when wiping. Blood may sometimes come from the urinary tract or rectum, and a clinician can help identify the source.

Assessment commonly covers hormone therapy, blood-thinning medicines, pain, discharge, and bleeding after sex. It may involve examination of the vulva, vagina, and cervix, followed by pelvic ultrasound or a sample from the womb lining when indicated.

Contact a gynaecology or primary-care service promptly for any new bleeding after menopause. Record when it began, how much you saw, its colour, whether it followed sex, and any pelvic pressure, discharge, urinary symptoms, or bowel symptoms.

Bring your medication and hormone-therapy details. Do not discontinue prescribed treatment without advice. If dryness or discomfort is present, mention it directly because examination can identify fragile tissue and treatment can be tailored once other causes have been considered.

Go for urgent assessment if flow is heavy, clots continue, or bleeding occurs with severe pelvic or abdominal pain, faintness, marked weakness, breathing difficulty, fever, or a rapid heartbeat. Call emergency services if you collapse or the bleeding cannot be managed safely at home.

Ask where the blood appears to be coming from, whether ultrasound or womb-lining sampling is advised, and when to expect results. Discuss whether hormone therapy or another medicine could affect bleeding, which treatment fits any identified cause, and what recurrence should lead to another appointment.