Bleeding after menopause: what to know

Menopause means periods have stopped for a sustained time. Bleeding afterwards can occur when vaginal or uterine tissues become thin and irritated, or from benign growths such as polyps. Medicines, hormone treatment and changes in the cervix can also play a part. Less commonly, bleeding is a presentation of cancer of the womb, cervix or vagina; bleeding alone does not show which cause is present.

A clinician may ask when the bleeding began, how much there was, whether it followed sex, and which medicines or hormones you use. Assessment can include an examination, an ultrasound and sometimes a sample of the womb lining.

Arrange a medical appointment even if the bleeding was light, happened once or has stopped. Note the colour, amount, clots, triggers and any pelvic pain. Bring a list of medicines, hormone products and prior gynaecological procedures. Do not assume spotting is caused by vaginal dryness without an examination.

Seek urgent medical help if bleeding is heavy or persistent, you feel faint or weak, you have severe pelvic pain, fever, or you are soaking pads rapidly. These features can signal significant blood loss or another problem needing prompt treatment.

Ask what area may be bleeding, which examination or scan is appropriate, whether a womb-lining sample is needed, and when results should be reviewed.