Richmond Practice - Post-menopausal bleeding

Post-menopausal bleeding

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Is bleeding after the menopause normal?
Menopause is defined as the total absence of menstrual periods for a year. The average age this takes place is 51 years, but the normal range is 45 years to 55 years. Any vaginal bleeding after menopause is abnormal. This can be hard to assess when women in their late forties and early fifties still have their period from time to time and is sometimes when problems occur.

There are many reasons for post-menopausal bleeding. The most common cause is vaginal dryness (atrophic vaginitis.) Polyps and fibroids can also occur in the womb and cause abnormal bleeding. Another common reason for abnormal bleeding is due to endometrial hyperplasia that can sometimes occur as a result of hormone replacement therapy (HRT). Endometrial hyperplasia is a thickening of the lining of the womb, caused by an abnormal overgrowth of the cells that line the womb. It is not endometrial cancer but in some women it can develop into cancer. It is important to exclude endometrial cancer in post-menopausal bleeding.

Trans-vaginal ultrasound (an internal scan) is used to assess the lining of the womb and ovaries. Sometimes we use a thin telescope to provide a detailed assessment and take a sample of endometrial cells for testing in the laboratory. This procedure is called hysteroscopy. The laboratory analyses the cell sample to exclude endometrial cancer.

Consult your doctor if you:
  • have any abnormal bleeding
  • are also taking hormone replacement therapy (HRT)
  • would like an ultrasound assessment of the lining of your womb and ovaries.

At Elsbeth's Doctors our female consultant obstetricians and gynaecologists are specialists who can assess your condition, and then recommend what you need to do. We can offer you a vaginal ultrasound, if required. Great care is taken to ensure you will feel comfortable and supported.



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