Postmenopausal bleeding

Menopause is usually diagnosed in women over 45 who have not had a period for more than a year. Any bleeding from the vagina after this time needs to be checked by a GP.

Non-urgent advice: See a GP if:

You have postmenopausal bleeding, even if:

  • it's only happened once
  • there's only a small amount of blood, spotting, or pink or brown discharge
  • you do not have any other symptoms
  • you're not sure if it's blood

Postmenopausal bleeding is not usually serious, but can be a sign of cancer. Cancer may be easier to treat if it's found early.

What happens at your GP appointment

If you have postmenopausal bleeding, a GP should refer you to hospital or a special postmenopausal bleeding clinic.

You should not have to wait more than 2 weeks to see a specialist.

What happens at your hospital or clinic appointment

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:

Causes of postmenopausal bleeding

There can be several causes of postmenopausal bleeding.

The most common causes are:

Less commonly, postmenopausal bleeding is caused by cancer, such as ovarian cancer and womb cancer.

Treatment for postmenopausal bleeding

Treatment for postmenopausal bleeding depends on what's causing it.

Causes and treatment for postmenopausal bleeding
Cause Treatment

Cervical polyps

The polyps may need to be removed by a specialist

Vaginal or 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 HRT treatment

Womb cancer

Total hysterectomy will often be recommended, often followed by radiotherapy, chemotherapy, or hormone therapy, or a combination of treatments

Ovarian cancer

Surgery to remove your ovaries, and sometimes your womb (total hysterectomy). You may also have chemotherapy.

Page last reviewed: 22 May 2023
Next review due: 22 May 2026