Dark blood after menopause: what to do

Low oestrogen can make vaginal tissue delicate and prone to irritation or bleeding. Pelvic organ prolapse may expose or rub tissue. Less commonly, bleeding can be linked to changes in the womb, cervix, or vagina, which is why an examination matters. Menopause can bring vaginal dryness, hot flushes, night sweats, mood changes, or low sex drive, but these symptoms do not explain away postmenopausal bleeding.

Contact a GP or gynaecology service promptly and describe the colour, amount, timing, and whether it followed sex or an examination. Mention medicines, including hormone treatment or blood thinners, and report pain, discharge, or urinary symptoms. A clinician may examine the vagina and cervix and arrange imaging or tissue sampling based on what they find. Avoid inserting products until you have advice if the area is sore.

Use urgent care for bleeding that is heavy or rapidly increasing, severe pelvic pain, dizziness, fainting, fever, or feeling very unwell. Otherwise, do not postpone a routine assessment simply because the bleeding is only spotting or has stopped.

Ask whether the bleeding could come from vaginal dryness, a prolapse, the cervix, or the womb; which examination is needed; and whether your medicines could contribute. Ask what symptoms should lead you to seek faster help and how results will be communicated.