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Postmenopausal Bleeding - Overview

Menopause occurs when a woman over 45 has not had a period for over a year. Any vaginal bleeding after menopause must be checked by a specialist. In the NHS you will have to visit your GP before being referred to a specialist. At Well Woman Clinic you can book to see a Consultant Gynaecologist immediately.

Please see a GP or a specialist if you have postmenopausal bleeding even if:

  • It's only happened once
  • There's only a small amount of blood, spotting or coloured discharge.
  • You don't have any symptoms apart from bleeding.
  • You're unsure if it's blood.

Although usually not serious, postmenopausal bleeding can be a sign of cancer. The earlier cancer is detected, the easier it is to treat.

What will happen during your appointment?

Our specialists will offer examinations and/or tests to help you find the cause of the bleeding. They will also recommend a treatment plan, if required.

Tests and examinations include:
  • Vaginal Ultrasound - A minimally invasive device will be placed in your vagina to assess its size, shape and to check for any abnormalities.
  • Pelvic/Vaginal Exam
  • Laparoscopic Hysteroscopy - A thin telescopic camera will be passed into your vagina, through the cervix and into the womb to look for problems and take a tissue sample.
Find out more about Postmenopausal Bleeding:
CausesDiagnosis and TestsTreatmentsPostmenopausal Bleeding Specialists
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Postmenopausal Bleeding Causes:

There are several potential causes of postmenopausal bleeding, including:
  • Atrophic Vaginitis/Endometrial Atrophy - Inflammation and thinning of the vaginal/uterus lining due to lower estrogen levels.
  • Polyps - Non-cancerous growths in the cervix or womb.
  • Thickened Womb Lining (Endometrial hyperplasia) - This can be caused by HRT (hormone replacement levels), being overweight or high levels of estrogen. It can also lead to womb cancer.

It is less common for postmenopausal bleeding to be caused by womb or ovarian cancer, but this should be checked.

How can Postmenopausal Bleeding be Treated?

Treatment for postmenopausal bleeding depends on the cause of the symptoms:
Cause
Treatment
Endometrial Atrophy (Uterus/Womb Inflammation and Thinning)
You may not require treatment, but may be offered a pessary or estrogen cream
Endometrial Hyperplasia (Thickened Womb Lining)
You may be offered no treatment, hormone tablets or an intrauterine system (IUS), or a total hysterectomy depending on the type of hyperplasia
HRT Side Effect
You may need to stop or change your HRT treatment
Uterine Cancer (Cancer of the Womb)
A total hysterectomy (full removal of the womb, cervix and ovaries) will likely be recommended.
Cervical Polyps
These may need to be removed by a specialist (click here for more information)
Ovarian Cancer
A total hysterectomy (full removal of the womb, cervix and ovaries) will likely be recommended.

Postmenopausal Bleeding - Specialists

Dr Mamta Pathak

Dr Mamta Pathak

Consultant Gynaecologist

Dr Mamta specialises in office Gynaecology consultations and procedures, having helped to establish and develop the office Gynaecology department in the Worcestershire Acute Hospitals.

Office Gynaecological procedures have made a significant clinical impact by removing the need for general anaesthesia, thereby allowing for a quick recovery following treatment.

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Dr Pallavi Latthe

Dr Pallavi Latthe

Consultant Gynaecologist and subspecialist Urogynaecologist

Dr Pallavi is an accredited subspecialist in urogynaecology and a consultant obstetrician and gynaecologist at the Birmingham Women’s NHS Foundation Trust.

She is the clinical lead for Paediatric and Adolescent Gynaecology in the Trust.

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