Common causes of postmenopausal bleeding

Other explanations include polyps and thickening of the womb lining. Cancer of the womb, cervix or vagina can also present with postmenopausal bleeding, so the cause should be checked even when the amount is small or it happened only once.

Postmenopausal bleeding means vaginal bleeding after periods have stopped because of menopause. It may look like spotting, pink or brown discharge, or a flow resembling a period. Fragile tissues associated with genitourinary syndrome of menopause may bleed after sex or without a clear trigger. Polyps and endometrial hyperplasia arise from the womb lining and can also cause bleeding.

A clinician may ask about medicines, hormone treatment and whether the blood could have come from the urine or bowel. Examination, imaging or a sample of the womb lining may be offered according to the findings.

Arrange a medical appointment promptly rather than waiting for another episode. Record when the bleeding started, its colour and amount, whether it followed sex, and any pelvic discomfort or unusual discharge. Bring a current medicine list, including hormones and blood-thinning medicines. Do not stop prescribed treatment unless the prescribing clinician advises it.

Seek urgent help for heavy or continuing bleeding, severe pelvic or abdominal pain, fainting, marked dizziness, weakness, breathlessness or clammy skin. These features can signal substantial blood loss or another problem requiring immediate assessment. Without those red flags, postmenopausal bleeding still warrants a prompt clinical review.

You could ask which examinations are appropriate, whether ultrasound or a lining sample is needed, how medicines may affect bleeding, and when results will be available. Also ask what changes should prompt urgent care while you are waiting.