Occasional bleeding after menopause: what to know

Bleeding after menopause can come from thinning or irritation of the vaginal or uterine lining, including genitourinary syndrome of menopause. Benign growths such as endometrial polyps, or thickening called endometrial hyperplasia, can also cause bleeding. Cervical or vaginal conditions may contribute.

Bleeding after menopause is also a presentation of womb cancer, cervical cancer, or vaginal cancer. This symptom does not establish a diagnosis, but its timing means it should not be attributed to ageing without an examination.

Book an appointment with a GP, gynaecologist, or menopause clinician and describe the colour, amount, timing, and source of the blood. Mention pain, discharge, urinary symptoms, medicines such as hormone therapy or blood thinners, and any previous cervical or uterine problems.

Assessment may include an examination, cervical screening when appropriate, an ultrasound, or a sample from the womb lining. Keep a note of further episodes and do not wait for bleeding to recur before arranging care. The right tests depend on your history and examination.

Seek urgent medical help if bleeding is heavy or persistent, you feel faint or weak, have severe pelvic pain, fever, or pass large clots. Emergency care is appropriate for dizziness, collapse, or symptoms suggesting significant blood loss. Report any new episode promptly even if it stops before you are seen.

Ask what may be causing the bleeding, which examination or scan is suitable, and whether you need a womb-lining sample. Ask when results will arrive and what changes should prompt faster review. If a serious condition is found, ask what treatment options apply; a radical hysterectomy is one operation used in selected cancers.