Bleeding after menopause needs checking

If you have gone 12 months without a period and then see blood, do not write it off as one last period or hormones playing up. A doctor needs to look at this, even if it happened once, was light and did not hurt.

• small spots or a trace of blood on your underwear
• pink or brown discharge
• bleeding after sex
• bleeding like a period

Most of the time the cause is not serious. Common reasons include thinning and dryness of the vaginal tissues, polyps on the cervix or in the womb, thickening of the womb lining, or the effect of hormone treatment. Less often, bleeding can be a sign of cancer of the womb. Found early, this is much easier to treat, which is why you should not wait.

The doctor usually asks some questions and does a pelvic examination. You may then have a vaginal ultrasound to look at the womb lining. If needed, a small sample of tissue is taken, or a tiny camera is used to look inside. It is rarely as bad as it sounds, and you can say in advance if you are worried about pain.

Some treatment plans include planned bleeds. Ask your doctor which bleeding is expected. Unexpected bleeding, bleeding outside the plan, or bleeding that keeps going still needs to be checked.