Post-menopausal bleeding: what you need to know

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Women over the age of 45 who have not had a period for over a year are usually diagnosed with menopause. After this point, any vaginal bleeding requires investigation as it is classed as abnormal bleeding. The cause is often something very treatable, but occasionally it can be symptomatic of a more serious disease. Make an appointment with your GP or directly with a private gynaecologist if you experience bleeding after the menopause.

What might cause bleeding after the menopause?

– Thinning and/or inflammation of the lining of your vagina or uterus.
– Growths called polyps in the cervix or uterus. Polyps are not usually cancerous.
– A thickened endometrium, which can be caused by taking HRT.
– Cervical or uterine abnormalities.

Around 10% of cases of abnormal bleeding post-menopause are linked to uterine or cervical cancer.

Post-menopause bleeding tests

If you have been diagnosed with post-menopausal bleeding, you will be referred to a gynaecologist. You may also choose to select your own private gynaecologist, particularly if you would prefer a female clinician or do not wish to wait for NHS treatment.

Treating abnormal bleeding depends on its cause, so a number of tests will be carried out. This can include taking your history and asking questions about your health, a physical examination, blood tests, and a colposcopy which involves looking inside your vagina and cervix and taking samples for testing.

Treating post-menopausal bleeding

The treatment you have will depend on the results of your tests and the cause of your bleeding. Your gynaecologist will discuss your treatment options with you once they have determined the reason behind your bleeding.

– Thinning of the vagina or endometrium can be treated with drugs that can come as a tablet, cream, skin patch or vaginal gel that slowly release medication.
– Polyps are usually removed surgically in a procedure called a hysteroscopy. This may be done under local or general anaesthetic depending on the size and location of the polyps.
– A thickened endometrium can be treated with medication.
– Gynaecological cancer such as uterine or cervical cancer will usually be treated with a hysterectomy or total (or radical) hysterectomy. This involves removing the uterus, fallopian tubes and both ovaries in a hysterectomy, as well as the cervix and upper parts of the vagina in a total hysterectomy.

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