Vaginal bleeding after the menopause or between periods: causes and next steps
Any vaginal bleeding after the menopause should be checked by a GP. It is often caused by something other than cancer, but womb cancer is one possible cause.
Key points
- NHS 111 Wales advises seeing a GP for any bleeding after the menopause, even a small amount of blood, spotting or pink or brown discharge.
- The NHS lists bleeding or spotting after the menopause as a main symptom of womb cancer, but it has other, more common causes.
- NHS inform says anyone with vaginal bleeding after the menopause is referred urgently, within two weeks.
- A scan of the womb lining is often the first test, and a small sample of the lining may follow.
What counts as bleeding after the menopause?
Bleeding after the menopause means vaginal bleeding once periods have stopped, and the NHS lists it among the main symptoms of womb cancer. NHS 111 Wales advises seeing a GP even if the amount is small, or if it is spotting or pink or brown discharge.
Does it mean cancer?
Bleeding has many possible causes, and cancer is a less common one. The causes NHS 111 Wales lists include thinning of the vaginal or womb lining from lower oestrogen, benign polyps and a thickened womb lining. Hormone replacement therapy (HRT) can also be linked with bleeding. NHS inform advises always seeing a GP about any unusual vaginal bleeding.
What about bleeding between periods?
The NHS lists bleeding between periods, unusually heavy periods and a change in vaginal discharge as other possible signs of womb cancer. NHS 111 Wales advice on heavy periods lists bleeding between periods or after sex as a reason to see a GP.
How quickly will someone be seen?
NHS inform says that a person with vaginal bleeding after the menopause is referred urgently, to be seen within two weeks. The NHS inform pathway describes Scotland, and referral rules can differ between UK nations.
What tests might be offered?
The first test is usually a transvaginal ultrasound scan, which measures the thickness of the womb lining. A small sample of the womb lining (biopsy) may follow, and some clinics use hysteroscopy, a look inside the womb with a thin camera. Treatment depends on the cause; for thinning of the vaginal lining it can include local oestrogen cream.
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