Consultant gynaecology · Central London EC1
Bleeding After the Menopause
Any vaginal bleeding more than 12 months after your last period needs investigating. Consultant assessment with pelvic ultrasound in the same appointment.
Most postmenopausal bleeding turns out to have a benign cause. It is investigated urgently in every guideline because a small proportion does not, and the difference is not something you can judge from the symptom itself. Speed matters more than worry.
Consultant-led · Same-visit pelvic ultrasound · From £300
What to expect
Assessment and imaging in one appointment
Your history
When the bleeding started, how heavy, whether it has recurred, and what medication or HRT you take.
Endometrial thickness
Transvaginal ultrasound measures the lining of the womb, which is the single most useful first measurement in postmenopausal bleeding.
Examination
Assessment of the vulva, vagina and cervix, since bleeding does not always come from the womb.
What the scan shows
Findings explained during the appointment, including polyps, fibroids and atrophy, which are common benign causes.
When more is needed
Where the lining is thickened or the picture is unclear, an endometrial biopsy or hysteroscopy is arranged rather than left with you.
Urgent referral
If findings suggest anything requiring urgent specialist care, referral is arranged the same day.
Fees
Published fees
Gynaecology Consultation
Full consultant consultation
£200
Consultation + Pelvic Ultrasound
Same-day scan and results
£300
Complete Well Woman Check
Consultation, ultrasound and cervical screening
£380
Common questions
Questions about bleeding after the menopause
Is postmenopausal bleeding always serious?
No. Most cases have a benign cause, commonly thinning of the vaginal tissue, polyps or the effects of HRT. It is investigated urgently in every guideline because a small proportion is caused by something that needs treating early, and the symptom itself does not tell you which.
What counts as postmenopausal bleeding?
Any vaginal bleeding occurring more than 12 months after your last period. That includes light spotting, brown discharge, and bleeding after sex. Amount does not determine importance.
I am on HRT and bleeding. Does that still need checking?
Yes. Unscheduled bleeding is common in the first few months of HRT and often settles, but it should still be assessed rather than assumed. Bleeding that starts after a settled period on HRT particularly warrants a scan.
What does the appointment involve?
A history, an examination of the vulva, vagina and cervix, and a transvaginal ultrasound measuring the thickness of the womb lining. Findings are explained during the visit.
Will I need a biopsy?
Not always. Where the lining is thin and the picture is clear, a scan may be sufficient. Where the lining is thickened or the appearance is uncertain, an endometrial biopsy or hysteroscopy is arranged.
Should I also see my NHS GP?
Yes, and it is worth doing both. Postmenopausal bleeding qualifies for an urgent NHS referral pathway. A private scan can give you an answer quickly, but it does not replace that referral route if further treatment is needed.
Get it looked at this week
Same-day appointments at 1-5 Portpool Lane, with pelvic ultrasound in the same visit. If you cannot get an appointment quickly, see your NHS GP as well: postmenopausal bleeding qualifies for an urgent referral pathway.