Why Is It Important to Investigate Perimenopausal or Postmenopausal Bleeding in Older Women?

(Patient Information Sheet)

What Is Perimenopausal and Postmenopausal Bleeding?

• Perimenopausal bleeding occurs during the transition to menopause when periods become irregular but have not stopped completely.
• Postmenopausal bleeding is any vaginal bleeding after 12 months of no periods (menopause).

Why Is It Important to Investigate Bleeding at This Stage?

Bleeding after menopause is not normal and must always be evaluated. It could be a warning sign of an underlying condition, some of which may be serious.

Possible Causes of Bleeding:

• Benign (non-cancerous) causes:
  • Thinning of the vaginal or womb lining due to low estrogen (atrophic vaginitis or endometrial atrophy)
  • Polyps (growths in the uterus or cervix)
  • Hormone replacement therapy (HRT)
• More serious causes:
  • Endometrial (womb) cancer
  • Cervical cancer
  • Ovarian cancer

Why Early Detection Matters:

• Most cases are benign, but 10–15% of postmenopausal bleeding cases are due to endometrial cancer.
• Early diagnosis can save lives—when caught early, treatment is more effective.
• Investigating bleeding ensures proper care and peace of mind.

What Will the Doctor Do?

• Take a full medical history and physical exam
• Perform a pelvic ultrasound to check the womb lining
• Possibly do a pap smear or biopsy of the womb lining (endometrial sampling)

When to Seek Help:

You should see a doctor immediately if you experience:

• Bleeding after menopause
• Spotting or discharge that looks like blood
• Heavier or irregular bleeding during perimenopause

Dr Sharad ObGynae
+6010 7778901