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"During the current COVID-19 crisis North West Gynaecology consultants are supporting the NHS and have had to reduce their private work due to NHS commitments. We are still able to offer consultations for existing patients if required, and depending on the degree of urgency, some new consultations, although this may need to be by telephone or video. Please contact our administration team to enquire about this"

Post Menopausal Bleeding (PMB)

What is postmenopausal bleeding?

This is vaginal bleeding which occurs more than twelve months after a woman’s last period after she has reached the menopause.  Unexpected bleeding in women who are taking hormone replacement therapy (HRT) should also be considered as post-menopausal bleeding.

What are the causes of post-menopausal bleeding?

There are many causes and most of them are not serious.  They include;

  • A delayed period, which can occur up to 2 years after the last normal period.
  • Thinning (atrophy) of the lining of the vagina and womb, common after the menopause.
  • Polyps which are small growths, are usually benign (non-cancerous) and found on the cervix (neck of the womb) or inside the womb. They are fairly common after the menopause.
  • A small number of women with post-menopausal bleeding have a more serious problem, such as cancer of the womb (uterus). For this reason it is advised that all women who have post-menopausal bleeding must see their doctor. The doctor will perform an examination and arrange certain tests and should refer the woman to a specialist clinic straightaway.

What are the tests needed to investigate post-menopausal bleeding?

An ultrasound scan. This is often carried out using a vaginal probe, most women find this test more comfortable than a smear test.

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.

A hysteroscopyis 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 e.g. 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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