Heavy bleeding with clots after menopause: what to know

After menopause, the womb should no longer shed a monthly lining. Clots can form when blood collects before leaving the body, but their presence does not identify the cause. Fragile vaginal or womb tissues, polyps, a thickened womb lining, and pelvic organ prolapse can contribute to bleeding. A serious womb or cervical condition is another possibility that must be ruled out. Menopause symptoms such as hot flushes, night sweats, or vaginal dryness may occur at the same time but should not be used to explain away clotted bleeding.

Contact a clinician promptly and describe the number and size of clots, how often pads need changing, when the bleeding began, and whether it follows sex. Mention pelvic pain, pressure, discharge, fever, dizziness, medicines, and hormone treatment. Use pads to monitor flow and keep any information that may help the assessment. An examination and tests may be needed to locate the bleeding.

Go to urgent care for rapidly worsening bleeding, repeated pad soaking, severe pain, faintness, unusual weakness, a racing heartbeat, or breathlessness. Do not wait for routine review if you feel unwell. Even if clots stop, arrange assessment because post-menopausal bleeding requires an explanation.

Ask whether the clots and flow change the urgency of assessment, which examinations or scans may be needed, and whether a womb-lining sample is appropriate. Ask how to manage bleeding safely while waiting for results.