Menopause is usually diagnosed in women over 45 who haven't had a period for more than a year. Any bleeding from the vagina after this needs to be checked by a GP.
Postmenopausal bleeding isn't usually serious, but can be a sign of cancer. Cancer is easier to treat if it's found early.
Your GP should refer you to hospital or a special postmenopausal bleeding clinic for further tests.
If you're over 55, you shouldn't have to wait more than 2 weeks to see a specialist. If you're under 55, you may have to wait longer.
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:
You'll be asked to remove your underwear and lie down on your back.
During the pelvic examination:
A pelvic examination can feel uncomfortable. Tell the specialist if you feel too uncomfortable and want them to stop.
There can be several causes of postmenopausal bleeding.
The most common causes are:
Less commonly, postmenopausal bleeding is caused by cancer.
Treatment depends on what's causing your bleeding.
|Cervical polyps||the polyps may need to be removed by a specialist|
|Endometrial atrophy||you may not need treatment, but may be offered oestrogen cream or pessaries|
|Endometrial hyperplasia||depending on the type of hyperplasia, you may be offered no treatment, hormone medicine (tablets or an intrauterine system, IUS) or a total hysterectomy (surgery to remove your uterus, cervix and ovaries)|
|Side effect of HRT||changing or stopping treatment|
|Womb cancer||total hysterectomy will often be recommended|