What should you know about viginal bleeding after menopause?

Bleeding can come from thinning, irritation or inflammation of vaginal or uterine tissues, polyps, or changes in the womb lining such as Endometrial Hyperplasia. Genitourinary Syndrome of Menopause may cause dryness and delicate tissue that bleeds after contact. Bleeding can also be a presentation of Womb Cancer, Cervical Cancer or Vaginal Cancer, so examination is needed even when the amount is small.

Assessment may include questions about the colour, amount, timing, pain, medicines and hormone treatment, followed by an examination. A clinician may recommend imaging or a sample of tissue depending on the findings.

Arrange a prompt appointment and record when the bleeding occurred, whether it followed sex, and any discharge, pelvic pain or urinary symptoms. Mention blood-thinning medicines and any hormone treatment. Do not use leftover treatments or assume that spotting can be explained by menopause without an examination. If a cause such as Endometrial Polyps is found, your clinician will explain whether observation or treatment is appropriate.

Seek urgent help for heavy or continuous bleeding, dizziness, fainting, severe pelvic pain, fever, weakness or shortness of breath. Emergency care is appropriate if you feel unstable or are soaking through protection quickly. Otherwise, contact a clinician promptly rather than waiting for the bleeding to recur.

Ask what examinations are needed, whether the womb lining needs imaging or sampling, which medicines could contribute, and when results will be available. If cancer is suspected or diagnosed, ask what specialist referral means and which treatments, including Radical Hysterectomy, might be relevant.