What should you know about postmenopausal bleeding after 10 years?

Bleeding after menopause, even after 10 years without periods, should be checked promptly because several causes are possible and some need treatment. Bleeding can come from fragile vaginal or cervical tissue, polyps, thickening of the womb lining, or cancer. The timing does not make it normal or explain the cause by itself.

Genitourinary Syndrome of Menopause can make vaginal tissue thinner, drier and easier to irritate. Endometrial Polyps are growths that may bleed, while Endometrial Hyperplasia is an overgrowth of the womb lining. Bleeding is also a common presentation of womb cancer, although bleeding alone does not establish that diagnosis. Less commonly, the cervix or vagina may be the source, including Cervical Cancer or Vaginal Cancer.

Arrange an appointment with a GP or gynaecology service and record when the bleeding started, its colour, amount and whether it followed sex. Assessment may include an examination, an ultrasound and, when indicated, a sample of the womb lining or a camera examination. Bring a list of medicines, especially hormone treatment or blood thinners. Results determine whether monitoring, local treatment, removal of a polyp or further surgery is appropriate.

Seek urgent care if bleeding is heavy or continuous, you pass large clots, or you develop faintness, severe pain, fever or unusual weakness. Emergency help is appropriate if you feel unable to stand safely or have symptoms of significant blood loss. Even light spotting needs medical review after menopause, including a single episode.

Ask where the bleeding may be coming from, whether you need an ultrasound or biopsy, how medicines could affect it, and when results will be available. Ask what changes should lead you to return sooner and whether a gynaecology referral is needed.