Slight bleeding after menopause

After menopause, the vaginal and uterine lining can become thin and fragile, causing spotting or bleeding, particularly after sex. Genitourinary syndrome of menopause may cause dryness, burning and irritation. Polyps or endometrial hyperplasia can also bleed. Less commonly, bleeding is a presentation of cancer of the womb, cervix or vagina. The amount of blood does not reliably show the cause, and bleeding may stop before an appointment.

Contact a GP or gynaecology service promptly and record when the bleeding started, its colour and whether it followed sex or a new medicine. Assessment may include an examination, ultrasound and sometimes a sample from the womb lining. Bring a list of medicines, including hormone therapy and blood thinners. Do not wait for bleeding to recur before arranging care.

Seek urgent help if bleeding becomes heavy, you feel faint or weak, or you develop severe pelvic pain, fever or shortness of breath. A small amount still needs routine medical assessment, but sudden deterioration should be treated as urgent. If you have already been referred, follow the service’s instructions about where to go if symptoms increase.

Ask which examinations are appropriate, whether the womb lining needs imaging or sampling, how medicines may contribute, and when you should expect results or further review.