How is bleeding after menopause treated?

Any bleeding after menopause should be checked, even if it happens once or is light. A clinician may ask about medicines, hormone therapy, sexual activity and the colour or amount of blood. Examination, ultrasound and sometimes a sample of the womb lining or a camera examination may be used to identify the source.

Treatment depends on the finding. Genitourinary syndrome of menopause can make vaginal or urinary tissues thin and prone to irritation; local treatment may help when that is the cause. Endometrial polyps may be removed, while endometrial hyperplasia may need medicines or a procedure. If cancer is found, care is planned with a specialist and may include surgery such as radical hysterectomy in selected situations.

Contact a clinician promptly and describe when the bleeding started, whether it followed sex, and whether you use hormone therapy or blood-thinning medicine. Do not wait for another episode before arranging assessment. Keep a note of bleeding and related pain, discharge, dizziness or urinary symptoms. Bring a list of medicines and any previous womb or cervical investigations.

Seek urgent care for heavy bleeding, fainting, severe weakness, severe pelvic pain, fever, or bleeding with a very unwell feeling. If bleeding is mild but recurrent, arrange prompt review rather than treating it as a normal period. A clinician may need to assess the cervix, vagina and womb lining, including for cervical, vaginal or womb cancer.

Ask what examination or tests are needed, when results will be available, and which causes are being considered. Ask whether a polyp, womb-lining change or vaginal tissue change could explain the bleeding, and what treatment would mean for sex, recovery and follow-up.