Slight spotting after menopause: what to know

After menopause, the vaginal and uterine tissues may become thinner and more easily irritated. Dryness, a small surface injury after sex, cervical changes, polyps, fibroids, or hormone treatment can cause spotting. Less commonly, bleeding can be a sign of a condition affecting the womb or cervix, so its appearance alone cannot identify the cause. Menopause can also bring vaginal dryness, hot flushes, night sweats, mood changes, or reduced sexual desire, but these symptoms do not explain away postmenopausal bleeding.

Arrange an appointment with a GP or gynaecology clinician. Record when the spotting started, how long it lasted, its colour, whether it followed sex, and whether you have pain, discharge, urinary symptoms, or use hormone medicines. Do not stop prescribed treatment without advice. An assessment may include an examination and, depending on your history, imaging or a sample from the womb lining.

Seek urgent medical help if bleeding becomes heavy, you feel faint or weak, develop severe or worsening pelvic pain, have fever, or pass large clots. Contact a clinician promptly for any repeat episode, bleeding after sex, or new watery or foul-smelling discharge.

Ask what examinations are appropriate, whether your medicines or vaginal dryness could contribute, and when you should expect results. Also ask which symptoms should prompt faster review.