Postmenopausal bleeding

When and where to get medical help

If you have postmenopausal bleeding you need to get it checked by a GP.

See a GP if:

• you’ve noticed bleeding from your vagina after your menopause, even if it’s only a small amount or it's only happened once

Cancer risk

Postmenopausal bleeding is not usually serious, but it’s important to get checked because it can be a sign of cancer. Cancer may be easier to treat if it's found early.

What happens at your GP appointment

If you have postmenopausal bleeding, a GP should refer you to hospital or a special postmenopausal bleeding clinic.

You should not have to wait more than 2 weeks to see a specialist.

What happens at your hospital or clinic appointment

A specialist, who may be a nurse, will offer you 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 speculum (plastic device) may be inserted into your vagina to hold it open, so the inside of the vagina and the cervix can be seen
• a thin, telescope-like camera being passed up your vagina, through the cervix 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
• the specialist pressing on your tummy and inside your vagina to check for lumps, tenderness or swelling.

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, such as ovarian cancer and womb cancer.

Treatment for postmenopausal bleeding

Treatment for postmenopausal bleeding depends on what's causing it.

Postmenopausal bleeding

Causes

Postmenopausal bleeding

Diagnosis

Postmenopausal bleeding

Medical treatments

Postmenopausal bleeding is often due to something harmless like thinning of the womb lining. Less often it can be something serious like womb cancer.

To find the cause of postmenopausal bleeding, you may have tests such as a vaginal scan, a pelvic examination or a hysteroscopy.

Treatment for postmenopausal bleeding depends on the cause. Treatment can include hormone treatments or sometimes surgery such as a hysterectomy.