What should you know about light bleeding after menopause?

After menopause, lower oestrogen can make vaginal and urinary tissues thinner, drier, and more likely to bleed with friction; this is called [Genitourinary Syndrome of Menopause](/conditions/genitourinary-syndrome-of-menopause/). Small growths such as [Endometrial Polyps](/conditions/endometrial-polyps/) can also bleed. Thickening of the womb lining, known as [Endometrial Hyperplasia](/conditions/endometrial-hyperplasia/), is another possibility. Less commonly, bleeding presents with [Womb Cancer](/conditions/endometrial-cancer/), [Cervical Cancer](/conditions/cervical-cancer/), or [Vaginal Cancer](/conditions/vaginal-cancer/). Bleeding alone cannot tell which cause is present.

Contact a gynaecology service or clinician promptly, even if the bleeding happened once, was only a pink smear, or followed sex. Record the date, amount, colour, clots, pain, and any discharge. Bring a list of medicines, hormone treatments, and relevant procedures. Evaluation may include an examination, cervical screening when due, and imaging of the womb; a sample of the womb lining may be recommended if needed. Do not use bleeding as a reason to self-treat with hormones or vaginal products before assessment.

Seek emergency care if bleeding is heavy or accompanied by fainting, marked weakness, severe abdominal or pelvic pain, or shortness of breath. Seek prompt medical review for any new bleeding after menopause, especially when it recurs, follows treatment, or occurs with weight change, pelvic pressure, or unusual discharge. If a cancer diagnosis has already been made, ask the treating team how to report new bleeding; [Radical Hysterectomy](/treatments/surgical-oncology/radical-hysterectomy/) is one operation used for selected pelvic cancers, not a general response to spotting.

Where could the blood be coming from? Do I need an ultrasound or lining sample? Could medicines or vaginal dryness contribute? How quickly should I receive the results, and what symptoms need urgent help?