POST MENOPAUSAL BLEEDING

This is the term used to describe red or brown vaginal bleeding when more than 6 months has elapsed since the last menstrual period.

Most women reach the menopause at about 52 years of age and periods lessen and then stop. 

Hot flushes may occur as the periods begin to lighten.

Unexpected vaginal bleeding may be heavy or consist of small red or brown discharges.

The main causes are:-
- A polyp growing inside the womb
- A small fibroid in the womb lining
- Dryness and thinning of the vaginal wall (atrophic vaginitis)
- A cancerous growth in the lower genital tract
- Unknown cause

When this happens the G.P. usually refers the patient to a gynaecologist who will –

Take a history including time of last cancer smear from the cervix
Examine and inspect the vagina and cervix  
Maybe take a tissue sample from the womb – a Pipelle endometrial biopsy
Arrange an ultrasound scan of the pelvis to measure and check the ovaries, the womb and the womb lining
Check the inside lining of the womb with a small instrument called a hysteroscope

If polyps or fibroids are detected they can be easily removed.  Vaginal dryness is treated with hormones for a short time.

If a cancerous growth is found then further investigations such as an MRI (magnetic resonance imaging) can be done and further surgery such as a hysterectomy may be advised.

Many women experience a small bleed that is of no significance and can be reassured that there is no pathology present, but only after all the tests and investigations have proved there is no abnormality.

Vaginal bleeding after the menopause should always be investigated because it is the early warning sign of cancer in a small percentage of older women.

At the Wellington Women’s Clinic we can give advice, investigate and treat this condition.

Please phone 020 7722 8328 for an appointment