What should you know about passing clots after menopause?

After menopause, the ovaries no longer produce the cycle pattern that causes regular periods. Bleeding or clots can come from the vagina, cervix, uterus, or urinary or bowel tract and may be related to thinning tissues, polyps, medication effects, or changes in the womb lining. Pelvic organ prolapse can also cause irritation or spotting, but it does not explain every episode.

Most causes are assessed through a history and examination, with tests chosen according to your symptoms. A clinician may ask when the bleeding began, whether it followed sex, and whether you take hormone therapy or blood-thinning medicine.

Arrange a prompt appointment with a gynaecologist or primary-care clinician, even if the bleeding has stopped. Note the colour, clotting, pain, dizziness, medicines, and whether blood appears on a pad or only when passing urine. Do not assume bleeding is a return of periods or a routine menopause symptom.

Go to emergency care for soaking bleeding, repeated large clots, severe pelvic pain, faintness, weakness, shortness of breath, or a racing heartbeat. Seek urgent advice if you feel unwell or take anticoagulants. Do not wait for another episode if the bleeding is continuing or worsening.

Ask where the bleeding may be coming from, which examination or imaging is appropriate, whether your medicines could contribute, and when results or further testing will be available.