Why should I see a specialist?
You may have been referred to this clinic because of your abnormal vaginal bleeding. For nine out of 10 women there is a simple explanation that usually needs little or no treatment. Your GP may refer you for assessment to exclude the small possibility of something more serious.
There is usually a simple explanation that requires little or no treatment
What is post-menopausal bleeding?
Post-menopausal bleeding is any vaginal bleeding after the menopause. It is assumed you have gone through the menopause if you have not had a period for at least six months. If you are on HRT this may cause you to have bleeding like a period. Abnormal bleeding on HRT or before you have gone through the menopause may also need to be investigated.
What are the causes of post-menopausal bleeding?
Most post-menopausal and other abnormal bleeding is caused by a change in hormones and usually needs no treatment. Sometimes if can be caused by a polyp that can easily be removed.
However, a significant cause of bleeding can be cancer of the uterus (endometrical cancer) or the cervix - although in fact only about one in 10 women with this symptom have such a serious diagnosis.
What are the tests needed to investigate post-menopausal bleeding?
- An ultrasound scan - Patients should expect to be in the scanning department for 20-30 minutes. A full bladder is required. The scan allows the doctor to accurately see whether there is any thickening of the lining of the womb (endometrium) and to look more closely at the ovaries.
- A biopsy of the lining of the womb (endometrium). This can be done in the clinic and involves a passing a thin tube through the cervix (neck of the womb) to take a sample. It feels rather like having a smear test, there is no cutting involved, it takes 30 seconds and is very safe.
- A hysteroscopy is sometimes necessary to look inside the womb using a thin telescope. This can usually be done without the need for an anaesthetic.
What treatment may be required for post-menopausal bleeding?
Often no treatment is necessary but if it is, it is usually simple. If a procedure is required, eg removal of polyps, it may be possible to do this in the clinic. A very small number of women with post-menopausal bleeding will require a major operation such as a hysterectomy (removal of the womb).
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