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  • Dr Peter Chew

Post menopause bleeding

I am 53 years old and haven’t had a period for three years. But I suddenly got my period again last week. Is it normal? Do I need to consult a gynaecologist? Any examination required?


You are having bleeding after menopause, which is not normal, even if it is just spotting.  The cause is usually minor, but cancer is always a possibility and must be ruled out. You have to consult a gynaecologist as soon as possible.The common causes are as follows:


Inflammation and thinning of the wall of the vagina (atrophic vaginitis) or womb lining (endometrial atrophy) due to a very low female hormone( oestrogen) level.


Non-cancerous growths of the neck of the womb( cervical  polyps) or the womb lining(endometrial polyps)


Thickened womb lining (endometrial hyperplasia) : if left untreated, this can lead to development of womb cancer (endometrial cancer)


Cancer of the vulva, vagina, neck of the womb(cervical cancer), womb lining(endometrial cancer) and ovary


Bleeding from the urinary bladder  or rectum


To find out the cause, the gynaecologist may perform the following examinations:

Pelvic examination: An instrument (speculum) is introduced into the vagina to look at the wall of the vagina and cervix. Swabs may be taken from your vagina and/or cervix to rule out any infection. A pap smear will also be done at the same time.


Vaginal ultrasound scan: This is performed by gently inserting a fine ultrasound probe into your vagina, to look at the lining of the womb and for tumour masses in the womb and ovaries.


Hysteroscopy: This is performed by passing a thin fine telescope (hysteroscope) through the cervix into the womb to look at its lining and remove a small sample of tissue for examination under microscope(endometrial biopsy).


Appropriate treatment will be given depending on the cause of your bleeding.