Bleeding after sex after menopause

After menopause, lower oestrogen can make vaginal and cervical tissues thinner, drier and more easily irritated. This is part of genitourinary syndrome of menopause and may cause soreness, burning or bleeding with penetration. A vaginal or cervical polyp, inflammation, or thickening of the womb lining can also be responsible.

Bleeding after menopause can sometimes be a presentation of womb cancer, cervical cancer or vaginal cancer. That does not identify the cause in an individual person, but it is why an assessment should not be delayed. The clinician may ask about hormone treatment, medicines, pain and the colour or amount of blood.

Contact a GP or gynaecology service and describe when the bleeding happened, whether it followed penetration, and whether it has recurred. Avoid anything that causes pain until you have advice; a water-based lubricant may reduce friction but should not replace assessment.

Evaluation may involve an examination of the vagina and cervix, and imaging or a sample from the womb lining if indicated. Ask how results will be communicated and what to do if bleeding returns. Treatment depends on the cause, which may include local treatment for tissue changes, removal of a polyp or specialist care for a cancerous condition.

Seek urgent care for bleeding that is heavy or does not settle, severe pelvic pain, dizziness or faintness, fever, or smelly discharge. Contact the service that arranged your assessment if bleeding returns while you are waiting, rather than assuming the original episode explains it.

Ask what examination is needed, whether the womb lining needs checking, whether dryness or pain could be contributing, and when results are expected. You may also want to ask what symptoms should prompt urgent contact and whether any current hormone or blood-thinning medicines affect the plan.