Causes of vaginal bleeding after menopause

Other explanations include cervical or vaginal inflammation and effects from some medicines or hormone treatments. Endometrial hyperplasia and cancers of the womb, cervix or vagina can also present with postmenopausal bleeding, so the symptom deserves investigation even when it happens once or appears only as pink or brown discharge.

This term covers vaginal blood, spotting, or blood-tinged discharge occurring after periods have stopped because of menopause. It may be seen on toilet paper, underwear or after sex. Blood can sometimes come from the urinary tract or bowel instead, and an examination helps locate the source.

Genitourinary syndrome of menopause can make vaginal tissue thin, dry and prone to bleeding with friction. Endometrial polyps may bleed unpredictably, while endometrial hyperplasia thickens the womb lining. The appearance of the blood does not reliably distinguish these conditions.

Book a medical appointment promptly rather than waiting for another episode. Note when bleeding began, whether it followed sex, any pelvic pain or unusual discharge, and all medicines or hormones you use. Tell the clinician if you are unsure whether the blood came from the vagina, urine or bowel.

Evaluation may involve a pelvic examination, inspection of the cervix and vagina, an ultrasound, or sampling the womb lining. The tests chosen depend on your history and initial findings; treatment is directed at the cause rather than the colour or volume of bleeding alone.

Seek urgent care if bleeding is heavy, you feel faint or weak, or it occurs with severe pelvic or abdominal pain, fever, breathing difficulty or a rapid deterioration in how you feel. Otherwise, any postmenopausal bleeding still warrants a prompt appointment, including a single small spot.

You might ask where the bleeding appears to originate, which examination or test is appropriate, whether a medicine could contribute, and when to expect results. If a tissue change is found, ask what it means, what treatment choices apply, and what future bleeding should prompt another review.