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Post-menopausal bleeding causes
Endometrial Polyps After Menopause
Endometrial polyps are a common structural cause of bleeding after menopause. Most are benign, but histology is important because risk is higher when bleeding is present.
Quick definition
Polyps are growths from the uterine lining. Most are benign, but tissue diagnosis matters after menopause.
Bleeding, post-menopausal status, and tamoxifen use increase concern for atypia or malignancy.
When to seek urgent care
- Heavy ongoing bleeding or symptoms of blood loss (dizziness, fainting, weakness).
- Bleeding with severe pain or fever.
- Recurrent bleeding despite prior “reassuring” tests.
If you are unsure, contact reception or your nearest emergency centre.
What this usually means
- Polyps are common and often benign.
- Risk of malignant or premalignant change is higher in post-menopausal bleeding than in premenopausal settings.
- Hysteroscopic removal is commonly recommended when bleeding is present.
How this is assessed
Assessment often starts with transvaginal ultrasound and/or endometrial sampling. Sonohysterography or hysteroscopy helps define focal lesions.
Step 1
Initial bleeding assessment
We assess risk factors, bleeding pattern, and perform examination.
Step 2
Endometrial evaluation
Transvaginal ultrasound and/or biopsy is used to evaluate the uterine lining.
Step 3
Targeted cavity assessment
Hysteroscopy or saline sonography is used when focal pathology is suspected.
Step 4
Definitive histology
Removed tissue is sent for pathology to confirm benign versus atypical/malignant change.
Treatment options by situation
Management is individualized, but bleeding-associated post-menopausal polyps are usually removed.
Hysteroscopic polypectomy
Preferred approach for symptomatic polyps, allowing treatment and diagnosis in one pathway.
Pathology-led follow-up
Follow-up depends on histology results and symptom pattern.
What happens next
Most people improve after treatment, but pathology results determine any further steps.
- Hysteroscopic removal when indicated.
- Pathology review to confirm final diagnosis.
- Reassess promptly if bleeding returns.
Because risk is higher after menopause with bleeding, treatment and pathology confirmation are usually recommended.
Next step: assessment helps us confirm diagnosis early and choose the right treatment pathway safely.
Common questions
Frequently asked questions
Are endometrial polyps usually cancer?
No, most are benign. But bleeding after menopause raises the need for tissue diagnosis.
Can a biopsy miss a polyp?
It can. Focal lesions are often better assessed with hysteroscopy or saline sonography.
If one polyp is removed, can bleeding still recur?
Yes. Any recurrent bleeding needs reassessment, even after prior treatment.
Need a plan today? We can assess urgency, explain findings clearly, and map your next steps.