Postmenopausal bleeding

Menopause happens when a woman’s periods stop. Women usually experience it between 45 and 55 years of age. After periods have stopped for more than a year, any bleeding from the vagina after this needs to be checked by a GP. The condition is called postmenopausal bleeding.

When to see your GP

See a GP if you have postmenopausal bleeding, even if:

  • it's only happened once
  • there's only a small amount of blood, spotting, or pink or brown discharge
  • you don't have any other symptoms
  • you're not sure if it's blood

Postmenopausal bleeding isn't usually serious, but can be a sign of cancer. Cancer is easier to treat if it's found early.

What happens at your GP appointment

Your GP will refer you to hospital or a special postmenopausal bleeding clinic for further tests. Depending on your age and symptoms, your GP will assess the risk, and if necessary, request an urgent appointment.

What happens at your hospital or clinic appointment

At your hospital or clinic appointment, you will be offered tests to help find out what's causing the bleeding and plan any necessary treatment.

The tests may include:

  • a small device being placed in your vagina to scan for any problems (vaginal ultrasound scan)
  • an examination of your pelvis and vagina
  • a thin, telescope-like camera being passed up your vagina and into your womb to look for any problems (a hysteroscopy) and to take a tissue sample (biopsy) for testing – under local or general anaesthetic

Causes of postmenopausal bleeding

There can be several causes of postmenopausal bleeding.

The most common causes are:

  • inflammation and thinning of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – caused by lower oestrogen levels
  • cervical or womb polyps – growths that are usually non-cancerous
  • a thickened womb lining (endometrial hyperplasia) – this can be caused by hormone replacement therapy (HRT), high levels of oestrogen or being overweight, and can lead to womb cancer

Less commonly, postmenopausal bleeding is caused by cancer.

Treatment for postmenopausal bleeding

Treatment will depend on what's causing your bleeding. Your health professional will discuss treatment options with you.

The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was published January 2018

This page is due for review November 2020

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