Question 1

What is postmenopausal bleeding?

Accepted Answer

Postmenopausal bleeding is any vaginal bleeding you experience after menopause. You reach menopause when you have not had a period for 12 months, and any blood spotting or brown discharge after this is not normal. If you notice bleeding from your vagina, it’s best to book an appointment with a doctor.

Question 2

What signs and symptoms come with postmenopausal bleeding?

Accepted Answer

Postmenopausal bleeding looks different for everyone, just as bleeding during periods does. You may notice:

Small amounts of blood or spotting on your underwear
Blood on toilet paper after you wipe
Bleeding similar to or heavier than a period
Blood clots that pass with other blood
Bleeding after vaginal intercourse
Pink or brown discharge from your vagina

The flow does not need to be heavy and may occur only once, although it can happen more frequently. However, it’s always worth speaking to a doctor. Some women also feel cramping with bleeding or spotting. You may also experience:

Changes in bladder or bowel movements
Fever
Chills
Headaches
Dizziness
Abdominal pain

If you experience uterine bleeding after menopause, whether or not you have other symptoms, we’re here to help. Our specialists will identify the cause and guide you to the best treatment for your health.

Question 3

What are some causes of postmenopausal bleeding?

Accepted Answer

Bleeding or spotting after menopause often isn’t serious, but it’s important to get it checked. The most common causes include:

Thinning of the vaginal or womb lining: Lower oestrogen levels can cause inflammation and thinning of the vaginal lining (atrophic vaginitis) and womb lining (endometrial atrophy), making them bleed more easily
A thickened womb lining: The lining may thicken (endometrial hyperplasia) due to high oestrogen levels, being overweight or hormone replacement therapy (HRT)
Polyps or fibroids: These are usually non-cancerous growths on the cervix or womb lining
Incorrect type or dose of HRT

Other reasons may include vaginal injuries or trauma, sex or infections in the cervix or womb. Blood from your bladder or rectum can also be mistaken for vaginal bleeding.

In rare cases, postmenopausal bleeding may be linked to womb, cervical or ovarian cancer. That’s why it’s vital to see a doctor quickly if you notice bleeding. At HCA UK, you can see a consultant gynaecologist within 24 hours to give you peace of mind.

Question 4

When should I see a doctor?

Accepted Answer

While postmenopausal bleeding isn’t always serious, you should never ignore it and should see your GP as soon as possible. Your GP will usually refer you to a postmenopausal bleeding clinic or one of our specialist gynaecologists for tests and a personalised treatment plan.

They’ll explain the reasons behind your bleeding and what to expect next. Even if you don’t need treatment, you’ll leave with reassurance and peace of mind. Many of our team are accredited by the British Menopause Society and trained in gynaecological cancer investigations and treatment.

They’re on hand to answer your questions, ease your concerns and make your journey from first visit to treatment plan as smooth as possible.

Question 5

How quickly should I see a doctor after postmenopausal bleeding?

Accepted Answer

You should contact your GP as soon as you notice any bleeding, even if it only happens once. It’s always best to get postmenopausal bleeding checked out. Most causes aren’t serious, but early assessment brings peace of mind and ensures that, if treatment is required, it can begin without delay.

Question 6

Can you get cramps and bleeding when you’re postmenopausal?

Accepted Answer

You can, but it’s not normal. Any spotting, heavy bleeding or brown discharge more than 12 months after your last period should be checked by a GP straight away. It may turn out to be nothing to worry about, but it’s always best to rule out any serious conditions or catch them early, when they’re easier to treat.

Question 7

What does brown spotting or discharge mean after menopause?

Accepted Answer

Brown discharge means blood has mixed with your vaginal discharge, which could be from recent or older bleeding. Spotting or brown discharge may point to a minor or more serious condition. If you notice it, book an appointment with your GP as soon as possible.

Question 8

Can stress cause postmenopausal bleeding?

Accepted Answer

Stress alone doesn’t usually cause postmenopausal bleeding. While stress can affect hormones and sometimes lead to spotting before menopause, any bleeding after menopause should always be checked by a specialist.

Question 9

Is postmenopausal bleeding after intercourse normal?

Accepted Answer

It’s not considered normal, but it can happen. Vaginal dryness and thinning of the vaginal lining in menopause make bleeding after sex more likely. Any postmenopausal bleeding should be checked by a GP. If other causes are ruled out, you may be advised to use lubrication during sex and possibly prescribed topical hormones to ease dryness and reduce friction.

Question 10

What does a “thick womb lining” mean, and how is it checked?

Accepted Answer

Your womb lining usually thins after menopause. If it thickens, it can trigger bleeding and needs investigation. Your specialist can check this with a vaginal ultrasound, which measures the thickness of the lining. If it’s greater than expected, you may be offered a biopsy or hysteroscopy.

Question 11

Are some women more likely to experience postmenopausal bleeding?

Accepted Answer

Yes, you may be more likely to experience postmenopausal spotting and bleeding if you:

Are on hormone replacement therapy (HRT)
Experience vaginal dryness
Have a history of fibroids or polyps
Are obese
Are diabetic
Have polycystic ovary syndrome (PCOS)

Having these risk factors doesn’t mean you will bleed, but they do increase the likelihood, so any unusual bleeding should be assessed promptly.

Question 12

Which sanitary products can I use if I have postmenopausal bleeding?

Accepted Answer

Which sanitary products can I use if I have postmenopausal bleeding?

It’s best to use sanitary pads rather than tampons or menstrual cups if you experience bleeding after menopause. Pads are more comfortable and allow you to monitor the amount of blood you’re passing. They can also reduce the chance of irritation or infection.

Tampons and menstrual cups aren’t usually recommended, as they can make symptoms harder to track.

Tampons and menstrual cups aren’t usually recommended, as they can make symptoms harder to track.

Question 13

Does a family history of womb or ovarian cancer increase the risk?

Accepted Answer

Yes, having a close relative with womb or ovarian cancer can raise your risk of postmenopausal bleeding and related conditions. It doesn’t mean you’ll definitely experience bleeding or develop cancer, but it does make it even more important to get any new bleeding checked promptly. Early reassurance or early treatment can help put your mind at rest.

Question 14

If I begin menopause late, am I more likely to experience postmenopausal bleeding?

Accepted Answer

Women who reach menopause later than average may have a slightly higher chance of experiencing postmenopausal bleeding. This is because their womb lining has been exposed to hormones for longer. While the risk is still low overall, you should always see a GP if bleeding happens, so they can investigate and give you peace of mind.