Published: February 2021
Updated: April 2025
Please note that this information will be reviewed every 3 years after publication.
Within this information, we may use the terms ‘woman’ and ‘women’. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs, whatever your gender identity.
A glossary of medical terms is available at A-Z of medical terms.
Text version: Post-menopausal bleeding poster
What is PMB?
Any vaginal bleeding after the menopause (12 months after your periods stop) is called PMB.
What causes PMB?
There are many causes for PMB such as:
- Growths from the lining of the uterus or cervix (polyps)
- Menopause related thinning of the vagina or lining of uterus (womb)
- Thickening of the lining of the uterus (endometrial hyperplasia)
Can PMB be a sign of cancer?
Less commonly, PMB can be a sign of cancer of the cervix, uterus or vagina.
1 in 10 women with PMB can have cancerous cells in the lining of their uterus.
9 in 10 women with PMB do not have cancer.
What should I do if I have PMB?
You should arrange to see your GP urgently so that it can be quickly investigated.
Can hormone replacement therapy (HRT) cause bleeding?
You may have some unexpected vaginal bleeding while taking HRT. This is common soon after starting or changing HRT.
However, you should still discuss this with your GP as it may need to be investigated to rule out other causes of bleeding.
What type of tests will I have?
Transvaginal (internal) ultrasound scan: this is done by inserting a probe into your vagina. This will show if the lining of the uterus is thickened, contains polyps, and has any other changes.
Hysteroscopy: this is done by passing a thin telescope through your cervix. A sample from the lining of the uterus (biopsy) may also be taken at the same time.
For some women, a vaginal examination, biopsy or hysteroscopy causes no or mild pain, but others find these procedures more painful. Your healthcare professional will discuss your options for pain relief, including having the procedure under general anaesthetic.
What are my treatment options?
You may not need any treatment. If treatment is advised, it will depend on the cause, and your healthcare professional will discuss this with you.
Sources and acknowledgments
This information has been developed by the RCOG Patient Information Committee.
Before publication this information was reviewed by the public, by the RCOG Women’s Network and by the RCOG Women’s Voices Involvement Panel.