What should you know about uterus problems after menopause?

After menopause, lower oestrogen can make vaginal and urinary tissues thinner and drier. This may cause dryness, soreness, discomfort with sex, urinary irritation, or light bleeding from fragile tissue. Fibroids, polyps, changes to the lining of the uterus, and pelvic organ prolapse are other possible explanations for pressure, pain, discharge, or a feeling of something bulging in the vagina.

Hot flushes, night sweats, mood changes, low sex drive, and stopped periods are commonly discussed as menopause symptoms, but they do not explain away bleeding after menopause. A clinician may need to examine the pelvis and assess the uterine lining to identify the cause.

Arrange a medical appointment for any vaginal bleeding, pink or brown discharge, new pelvic pain, unusual discharge, or a new pressure or bulge. Note when it happened, how much there was, whether sex preceded it, and any pain or urinary changes. Do not insert products or start hormonal treatment for unexplained bleeding without medical advice.

If dryness or painful sex is the main issue, mention it specifically. Treatment depends on the tissue involved, your medical history, and whether bleeding has been explained.

Seek urgent help for heavy bleeding, severe or worsening pelvic pain, fainting, marked weakness, fever, or a painful prolapse that cannot be eased. Contact a clinician promptly even when bleeding is only spotting, because post-menopause bleeding needs a clear explanation.

Could the bleeding come from vaginal tissue, the cervix, or the uterus? Do I need an examination or imaging? What can help dryness or pressure safely? Which symptoms should make me seek urgent care?