Why postmenopausal bleeding always needs checking
Once you're postmenopausal — 12 months or more since your last period — you shouldn't have any vaginal bleeding. Even light spotting or a pink or brown discharge counts. It doesn't mean something is seriously wrong, but it does mean you need to see a doctor promptly so the cause can be identified.
The reason for the caution is that postmenopausal bleeding is the most common symptom of endometrial (uterine) cancer. Importantly, most women with postmenopausal bleeding do not have cancer — but because it can be a warning sign, it's always investigated.
Common causes that aren't cancer
The most frequent cause is thinning of the vaginal and womb lining due to low oestrogen (vaginal or endometrial atrophy), which can bleed easily. Other causes include benign polyps, the effects of menopausal hormone therapy, infection, or irritation.
Because these causes look similar from the outside, a GP can't tell them apart without assessment — so the same investigations are done regardless of how light the bleeding is.
What happens when you see a doctor
Your GP will ask about the bleeding and your history, and usually arrange a pelvic ultrasound to look at the thickness of your womb lining. Depending on the findings, you may be referred for a simple procedure to sample the lining (a biopsy) or a hysteroscopy.
The key message: don't wait and see. If you have any bleeding after menopause, book an appointment. Getting it checked quickly is reassuring in most cases and important in the few where it isn't.
Related condition
Menopause & perimenopause →References & sources
- 1.Menopause — Jean Hailes for Women's Health
- 2.Menopause — Better Health Channel
- 3.Hormone replacement therapy — healthdirect
- 4.Post-menopause — healthdirect
- 5.Menopause health info — Australasian Menopause Society
This content is general information and not a substitute for individual medical advice. Please consult a GP for your personal situation.
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