Postmenopausal spotting: what to know

After menopause, lower oestrogen can make vaginal and cervical tissue thinner and more easily irritated. Dryness, inflammation, a vaginal infection, or a polyp may cause light bleeding. Medicines and hormone treatment can also affect bleeding. Endometrial Polyps and other changes in the uterine lining may be involved. Womb Cancer and Cervical Cancer can present with postmenopausal bleeding, so the symptom should not be dismissed even when it is a small amount or happens once.

Bleeding from the vagina, cervix, bladder, or rectum can sometimes look similar. A clinician can help identify the source and decide whether an examination, swab, scan, or tissue sample is needed.

Arrange a medical appointment promptly and describe the colour, amount, timing, recurrence, and any trigger such as sex. Bring a list of medicines, hormone treatments, and relevant procedures. Mention pelvic pain, discharge, odour, urinary symptoms, or bowel bleeding. Avoid inserting products or having penetrative sex if they cause discomfort or more bleeding until you have advice. Do not wait for another episode before arranging assessment.

Seek urgent help for heavy bleeding, clots with weakness, severe abdominal or pelvic pain, fever, faintness, or shortness of breath. If bleeding is accompanied by new severe symptoms, use emergency services. Even without pain, postmenopausal spotting warrants timely clinical review so treatable causes and more serious causes can be distinguished.

Could dryness, a polyp, infection, medicine, or the uterine lining explain this? What examination or tests are appropriate? How can vaginal discomfort be managed safely while the cause is being checked?