Heavy bleeding after menopause: what to know

Menopause means periods have stopped; bleeding afterwards is different from a late or heavy period. Thinning or irritation of vaginal or womb tissues can cause bleeding, and polyps or a thickened womb lining can also be involved. Pelvic organ prolapse may cause local irritation or bleeding. Less commonly, bleeding can be linked to a serious womb or cervical problem, so the cause cannot be identified from the amount or colour alone. Other menopause symptoms such as hot flushes, night sweats, mood changes, low sex drive, or vaginal dryness do not explain away bleeding.

Arrange a medical assessment rather than waiting for another episode. Write down when the bleeding started, how much there was, whether it followed sex, and whether you have pain, discharge, urinary symptoms, or bowel changes. Tell the clinician about medicines, hormone treatment, and any previous womb or cervical problems. Examination and further tests may be needed to find the source.

Use urgent medical care for heavy or rapidly increasing bleeding, repeated soaking of pads, severe pelvic pain, faintness, marked weakness, shortness of breath, or a fast heartbeat. Seek prompt advice even when the bleeding is small, painless, or has stopped, because post-menopausal bleeding still needs an explanation.

Ask what could be causing the bleeding, whether you need a pelvic examination, ultrasound, or a sample from the womb lining, and how quickly results will be available. Ask which symptoms should send you to urgent care while you wait.