Red spotting after menopause: what to know

Low oestrogen can make vaginal or cervical tissues thinner and easier to irritate. Dryness, inflammation, polyps, some medicines, and pelvic organ prolapse can also cause bleeding. A red mark on toilet paper, pink discharge, or a small episode all count as spotting.

Postmenopausal spotting cannot identify its own cause. Womb cancer can present with bleeding after menopause, although other explanations are more common. An examination may include a pelvic examination, ultrasound, or a sample of the womb lining, depending on your history and findings.

Contact a doctor or gynaecology service and describe timing, amount, colour, and whether it followed sex. Mention dryness, pelvic pressure, new medicines, hormone treatment, or previous polyps. Use a pad if bleeding continues and avoid douching or scented products.

Do not wait for a second episode before arranging advice. Bring a medicine list and previous results. Treatment can be chosen after the cause is identified.

Seek urgent help for heavy bleeding, severe pelvic or abdominal pain, faintness, marked dizziness, fever with feeling very unwell, or rapidly worsening symptoms. For lighter spotting, arrange a prompt appointment rather than assuming it is dryness or a returning period.

Ask what may be causing the bleeding, whether you need a pelvic examination or ultrasound, and whether the womb lining needs sampling. Tell the clinician about hormone therapy, blood-thinning medicines, pain, discharge, and previous abnormal results.