What could postmenopausal bleeding mean?

Postmenopausal bleeding means vaginal bleeding after you have had no period for at least 12 months. It is often caused by thinning tissues or polyps and is usually not cancer, but womb cancer must be excluded. Arrange a GP appointment even for one episode, spotting or pink or brown discharge.

Does postmenopausal spotting count?

Yes. A small amount, one-off spotting, or pink or brown discharge should all be checked.

Is postmenopausal bleeding always cancer?

No. Most cases are not cancer, but assessment is necessary because cancer is one possible cause.

What tests might be offered?

Assessment may include examination, transvaginal ultrasound, hysteroscopy and a small sample of the womb lining.

Postmenopausal bleeding: When to See a GP

Who should skip this page?

Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland.

Possible causes

Common causes include thinning of vaginal or womb-lining tissue, cervical or womb polyps, and thickening of the womb lining. Less commonly, cancer is responsible.

Referral and assessment

GPs commonly refer postmenopausal bleeding through an urgent pathway. Urgent does not mean cancer is expected; it ensures timely exclusion.

HRT and bleeding

Some bleeding is common when starting or changing HRT. Report bleeding outside the pattern explained by your prescriber, after it should have settled, or whenever it is heavy.

Common questions about postmenopausal bleeding

Does postmenopausal spotting count?: Yes. A small amount, one-off spotting, or pink or brown discharge should all be checked.
Is postmenopausal bleeding always cancer?: No. Most cases are not cancer, but assessment is necessary because cancer is one possible cause.
What tests might be offered?: Assessment may include examination, transvaginal ultrasound, hysteroscopy and a small sample of the womb lining.

Sources

NHS — Postmenopausal bleeding

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Postmenopausal bleeding