Many women have different concerns about vaginal bleeding, if these are related to the cervix then further details can be found in that section.
If you suffer with bleeding after the menopause you will be seen in the PMB (post menopausal bleeding) clinic where a doctor will talk to you and generally perform an examination and a vaginal ultrasound scan. After the scan many women with this complaint have no significant abnormality and can be discharged after a single visit to the clinic. Some women will have a biopsy performed in the clinic where a speculum (which is the same device used in cervical screening tests) is inserted into the vagina and a small thin plastic tube is passed through the neck of the womb (cervix) into the uterus. This can be a little bit uncomfortable and you can expect some light bleeding for a few days after the test. Depending on the findings from the scan, the doctor in the clinic may recommend another procedure called a hysteroscopy. A hysteroscopy is generally done at a later date and there is a leaflet available with further details. In only a small proportion of cases there may be a serious cause for the bleeding, such as endometrial cancer (cancer of the lining of the uterus).
Unusual bleeding in between the periods is another reason why your gynaecologist would suggest a hysteroscopy. A frequent cause of this is endometrial polyps that can be removed at the same time as the hysteroscopy.
If you are experiencing heavy periods your doctor will need to discuss different treatment options that are right for you. This may include different medications, contraceptives including the mirena coil, endometrial ablation or even, for the minority of women, a hysterectomy. Leaflets are available on these treatments.
Patient information leaflets:
About Novasure Endometrial Ablation
Laparoscopic subtotal hysterectomy
Esmya (ullipristal acetate) for fibroids