When to worry about bleeding after menopause with vaginal cancer

Vaginal cancer can affect the vaginal lining and may cause spotting, bleeding after sex, watery or blood-stained discharge, a sore area, pelvic pain or discomfort when passing urine. These signs can also arise from irritation, infection or other gynaecological conditions. Symptoms alone cannot tell which cause is present, so an examination is needed.

Arrange a prompt appointment with a doctor or gynaecology service. Write down when the bleeding started, how much there was, whether sex or an examination preceded it, and any discharge, pain or urinary symptoms. The clinician may examine the vagina and cervix and recommend further tests or a biopsy if an unusual area is seen.

Seek urgent help for heavy bleeding, faintness, severe pain, fever, new weakness or breathlessness. Contact a clinician promptly for repeated spotting, bleeding after sex, a persistent sore or lump, unpleasant discharge, or trouble passing urine. Do not wait for a routine screening visit to discuss new bleeding after menopause.

Ask where the blood appears to be coming from, what the examination shows, whether a biopsy or imaging is appropriate, and how results and follow-up will be arranged. Ask which symptoms should prompt urgent reassessment.