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Post Menopausal Bleeding

For many women, the menopause brings to an end the prospect of undergoing monthly periods and the possibility of being able to get pregnant via natural means. Having gone through this lengthy process, it’s understandable that the occurrence of postmenopausal bleeding can be unsettling and a source of great anxiety for those who experience it.

Whilst post-menopausal bleeding can be concerning, there are many reasons for this – and these are often inspired by the fluctuating levels of oestrogen present in the body in the years after a final period. 

Some common causes

Whilst largely unexpected, it’s not uncommon for women to bleed from the vagina despite having gone through the menopause. This bleeding might feel like it’s come out of the blue, but when explored in greater detail, this worrying occurrence can be easily explained:

  • Endometrial atrophy: As oestrogen levels decline, the lining of the uterus can thin and weaken considerably. This often results in vaginal bleeding.
  • Endometrial hyperplasia: Despite the menstrual cycle reaching its end, oestrogen levels can surge to high levels and contribute to the thickening of the womb lining. This sometimes results in vaginal bleeding. This abundance of oestrogen can either occur naturally or as a product of hormone replacement therapy (HRT) – a form of medical intervention designed to help women cope with the hormone loss brought about by the menopause. If endometrial hyperplasia is identified as the source of the bleeding, it is important to treat this as soon as possible as this can lead to the development of womb cancer.
  • Polyps – Growths that can inhabit the womb or the cervical canal, polyps are usually non-cancerous but can normally cause bleeding, spotting or bleeding after sex. 
  • Genitourinary syndrome of menopause (GSM)- Post menopause, lower oestrogen levels can leave women in significant vaginal discomfort. This can take on the form of dryness, irritation, thinning or inflammation and can often lead to bleeding after sex.
  • Cancer – In post-menopausal women, vaginal bleeding is a common symptom of several forms of cancer, including endometrial cancer, cervical cancer and vaginal cancer.

Achieving a diagnosis 

Regardless of how little or infrequently you have encountered vaginal bleeding after going through the menopause, it’s always advisable to contact a medical professional as soon as possible. From here, they will work alongside you to achieve a diagnosis and may ask you to undergo a range of different investigative tests. Once the cause of your bleeding has been identified, there are several ways of managing this issue including medication, hormone therapy and a hysterectomy. 

Mr Francis Gardner 

There’s no medical professional more qualified to help you on your path to diagnosis than a specialist in Advanced Gynecology. Over the course of his career, Mr Francis Gardner has established himself as one of the pre-eminent figures in this field and, with his knowledge, expertise and professionalism, has helped many patients through their gynaecological journeys.  To book in for a consultation with Mr Gardner or a One Stop See and Treat, get in touch today. 


The menopause can be a lengthy process with its own recognisable set of symptoms. This can be said to have officially come to an end if you haven’t had a period for at least a year, and you’re a woman of menopausal age (45+).


Although fairly common, post-menopausal bleeding is usually a sign of something happening within your body. You should contact a medical professional as soon as you experience any post-menopausal bleeding, no matter how insignificant.


There are several methods used to identify the source of your vaginal bleeding. These include pelvic and vaginal examinations, vaginal ultrasound scans and hysteroscopies – procedures in which the womb is investigated with a camera and a sample of tissue taken for testing.

Depending on what is identified as the cause of your post-menopausal bleeding, you will be provided with a range of treatments. This includes growth removal, hormone therapy or a full or partial hysterectomy.