Menopause symptoms and bleeding between periods

Hormone fluctuations before menopause can change ovulation and the womb lining, producing spotting or irregular flow. Other possible causes include cervical dysplasia, cervical cancer, chlamydia, endometrial polyps, fibroids, and changes in the womb lining. Vaginal or cervical irritation, including bleeding after sex, is another possibility.

Bleeding is a symptom, not a diagnosis. The pattern, pregnancy possibility, age, medicines, contraception, and examination findings help guide assessment. After menopause, any vaginal bleeding is treated as postmenopausal bleeding and should be checked, even when it is light.

Write down the first and last day of bleeding, whether it was spotting or a flow, whether it followed sex, and any pain or discharge. Bring a list of medicines and contraception. A clinician may examine the vagina and cervix and arrange tests such as swabs, imaging, or sampling of the womb lining when appropriate.

Seek urgent help for heavy bleeding with dizziness, fainting, severe weakness, or severe pelvic pain. Arrange prompt medical review for bleeding after sex, bleeding that keeps recurring, bleeding with unusual discharge or pelvic pain, or any bleeding after menopause.

Ask what causes are most relevant to your pattern, whether you need cervical screening or infection testing, and whether the womb lining should be assessed. Ask when results are expected and which symptoms require urgent contact.