Bleeding after menopause

When there is bleeding after menopause, checking for abnormal thickening of the uterus lining is the most important consideration. But sometimes other problems are present, such as polyps, fibroids, or collection of fluid in the uterus. Some women are also experiencing pelvic pain with the bleeding or are worried about their ovaries and possible cancers.

If your request is linked to symptoms of bleeding after menopause, then an abdominal and vaginal scan is usually required.

Usually our gynaecological ultrasound consists of an abdominal ultrasound and a vaginal ultrasound.

The abdominal scan gives a good overview, as long as the bladder is well-filled. The vaginal ultrasound (although it sounds awkward) is usually a much gentler procedure than a cervical smear. It allows the images to be taken from much closer to the uterus and ovaries, which usually gives better detail.

After the menopause the vaginal scan may be less helpful, either because narrowing of the vagina makes the examination less comfortable, or because the smaller, straighter uterus is more difficult to view from that approach. For this reason, it is a good idea to drink 2 glasses of water 3/4 hour before the appointment. That way, images can be taken through the bladder first, before emptying to try the vaginal scan.

If you have already had a successful vaginal scan with us in the last couple of years, you may have been told not to worry about filling your bladder for subsequent appointments.