Post menopausal bleeding after 17 months

[Finaly]

Hi, I'll start by saying I will be contacting my GP tomorrow about this but I'd appreciate hearing from anyone whose been in a similar position.

I'm 56 and haven't had a period for 17 months. Over the last few years I've had 4 spells of 6 months of no periods before they started again.

On Sat past I felt awful, couldn't work out what was wrong. On Tue at lunch time I felt what used to be a sign my period was coming, one 30 incident twinges in.my left ovary area. Wed morning slight bloody discharge before properly bleeding later in the day. What ever is going on has started and preceeded just like a usual period. No other obvious symptoms.

Has anyone experienced this who has gone to their GP willing to share their experience please? I'm trying not to panic by telling my self it's a glich/one last period but I am worried.

Yes, it’s happened to me twice. Put on the two week wait pathway, had ultrasound, hysteroscopy, biopsy. Biopsy was fine. Wall of the uterus was slightly thickened so they put in a mirena coil to stop the thickening. No problem since. Please do ask for local anaesthetic for the procedure as it can be painful.

Thanks, that sounds positive. Off to Google the last two procedures you mentioned...

Me. Twice been put on the two week cancer pathway. Twice had hysteroscopy. Both times outcome was thickening of wall with no reason and no further action.
My experience with the hysteroscopy was not good but others have experienced only mild discomfort.

Do they always do a hysteroscopy? Do they do other tests first?

I have just had this 5 years since menopause. Very
frightening but main thing is to get ultrasound and scan done. I have had a hysteroscopy even though no thickening of womb lining. Am waiting for biopsy results, fingers crossed I think my estrogen hrt dose was too high and the progesterone not high enough, causing bleeding. I'm going back on lower dose of estrogen and hopefully it will all settle. Best of luck, make sure you go to GP and get referred for tests x

Thank you, I'll be calling tomorrow. I'm not on HRT, but I could be doing with losing a few stones. I understand fat cells can increase estrogen levels so it may be linked.

Fingers crossed for your biopsy results. X

Don't always do one. I had a scan and it showed a large cyst which needed removing. You should be put on the w week pathway,don't be alarmed ,it's a good thing as you'll get seen quickly.

Thanks, I have an appointment with the GP on Thursday morning. I've had miscarriages/ early pregnancy concerns in the past so I've had a few of the internal scans so while not pleasant I'm not to worried as I know what happens.

This has very much been identical to a period from start to finish so I'm trying to remain positive by telling myself it's just a glitch, otherwise I know I'll start to think the worst.

I've just had my second internal scan, hysteroscopy with biopsy and Mirena coil (first was at 61, I'm 65 now)
Just waiting for the biopsy results.
I echo what a PP said about asking for the local anaesthetic, I found it very uncomfortable....

Thank you, I'll definitely bear that in mind if I need one.

I've never had any kind of coil fitted before, if the scan results are okay would they wait to see if the bleeding continued or became problematic before suggesting a coil do you know?

For me, both times the scan results didn't show anything cancerous or concerning apart from the womb lining being thicker than it should be (including the most recent time, considering I had a coil already) so the coil was suggested as a way of making sure the bleeding stopped (which it did for 3 years)
Good luck.

I have just been investigated for bleeding while on continuous HRT (after 18 months of cHRT and no bleeding whatsoever). Same as you it felt exactly like being premenstrual and then having a period, I'm 54.
The GP referred me on the 2 week wait pathway, I was seen in gynae clinic within a week and had a transvaginal scan which showed a thickened endometrium. I was offered a choice of hysteroscopy (which I may have had to come back for but would be able to have pain relief while it was done) or a pipelle biopsy which could be done there and then but with no pain relief (although not considered to be as painful as hysteroscopy). I opted for the pipelle which is a long and very narrow plastic cannula introduced into the uterus via a speculum, and some of the womb lining cells are then removed through the cannula using suction from a syringe. It was definitely quite uncomfortable when the syringe bit was being done but it was more like unpleasant crampy pains and it was bearable (the nurse practitioner carrying out the procedure had pre-warned me what to expect and I had another nurse as chaperone who was very kind throughout). If she hadn't managed to get a sample I would have had to consider hysteroscopy but fortunately it went as planned. Results were back within a week showing nothing worrying, but if bleeding recurs they would recommend considering a Mirena coil to keep the uterus lining thin.
It wasn't the best afternoon I've ever had but it was quick and thorough and ruled out anything worrying so I'm glad I did go to the GP.

Guy’s hospital do a one stop shop for this - so you have an ultrasound, where they measure womb thickness and fibroids etc, then you wait a bit and go and have a hysteroscopy. I had the coil inserted while they were ferreting about down there. It should be quick, but I had an awful doctor once who couldn’t get to the womb for the biopsy, and shouted at me that it was because I was fat, and because I was fat was also the reason that I had had malignant melanoma. I refused to let her do any more damage to me and booked with another doctor, who did the whole procedure the following week in about ten minutes, and said I had a high uterus, so the previous doctor should have used a longer speculum, and it wasn’t to do with my weight.

Thanks everyone, been to the GP and referral is being made to gynae specialists, I had to see the practice nurse for an internal first otherwise the referral would have been bounced back. She's great and from her perspective what she could see looked okay, cervix closed and looking as expected and no old or new blood present. She's got around 40 years experience and has said it's not uncommon to have a period/bleed at this stage and while it's probably nothing it needs checked out to be on the safe side.

GP was fine, he just asked when my last period was, what my bleeding had been like, if I was on HRT (no), if I was up to date with my smear tests (yes) and then explained what I already knew which was that he needed to refer me and that they'd do further tests.

I had similar OP. 2 years after my last period I randomly ovulated (I always got mittelschmerz) and had a mini period.

I was fast tracked for a hysteroscopy within 2 weeks. There was no obvious cause and everything was fine.
The gynaecologist told me sometimes that can happen and it was nothing to worry about.
Handily she also noticed some early atrophy which I had no symptoms of so I was put on vaginal oestrogen and have been on it since.

I think the whole experience did me a huge favour as up until then I'd never even heard of vaginal atrophy.

The hysteroscopy doesn't hurt at all btw and is a bit like a smear with more bells and whistles.

I have a thread about this very thing. 56, last period was Jan 2025, then started bleeding in Feb 2026. Felt exactly like a period, lasted a week, stopped for a week, and has now started again.

I have a gynae apt for a scan next week.

If you need a hysteroscopy you can ask for general anaesthetic. You need to ask for it in advance. Some women find them extremely painful, there is a campaign group against doing them with no pain relief.

Some women also find them relatively painless. It wasn't a risk I was willing to take! I had a GA and the gutted a coil at the same time.

Hi @Finaly

I am 58, had what I thought was a UTI, just before Christmas. I am post menopausal since 2015. I had no post menopausal bleeding therefore, I was not concerned but the lower pelvic pain was bothersome.

My GP, ordered a pelvic scan, in turn, I had a TVS at the same time. This has shown up an endometrial polyp of 16mm x 7mm x 12mm in my fundal endometrium. That was at the back end of January. On returning to my GP as a follow up, she put me on the 2week pathway and I saw gynie yesterday. Expecting to have another TVS and further tests at the one stop shop, he went straight to removal of the polyp under GA which I am now waiting for.

I do not take HRT nor have I ever & as no bleeding, I am not unduly worried. You appear to be on the correct pathway & a hysteroscopy ( i have had before, biopsy for a thickened womb lining in 2019 & all came back fine)

Best of luck.

This is extremely common and less than 1% of women investigated show up with any pathology.

Premenstrual like symptoms accompanying it make it even more likely to be a random last ovulation.

The 12 month rule employed in diagnosing menopause and investigation of any bleeding thereafter is completely arbitrary - they could quite easily have settled on 10 months or 18 months.

@Freedomsjustanotherword fingers crossed everything goes well for you.

@Charliede1182 , that's interesting re the 12 month thing. I'm sure in my mum's time (she's 80 so 30 years ago) it was 2 years. I think that's why I was quite surprised by the 12 month thing, in my mind I'd thought it meant I had to go back to start counting from the beginning again. I've had about 4 times when my period had just stopped dead for 6 months then started up again as usual and I thought this was similar.

I was put on the 2WW pathway to the one stop shop, when I had what seemed to be a very light period after at least 3 years with nothing. I wasn't on HRT and the gap was long, so I was worried but all was fine. I just had the ultrasound in the end - lining wasn't thickened so I didn't need a hysteroscopy (tho I went prepared, took painlkillers before).

If you get a choice of referral, I'd recommend the one stop shop system from my and others' experience.

Try not to worry - the system is a good way of picking up the rare cases ealier than would happen otherwise, but as pp have said, in the vast majority if cases all is well.

Thanks @MsMartini the GP said he'd refer me to gynae but my health board's website says it has a PMB clinic so I'm not sure what it will end up being. If I recall from reading the leaflet it did say to take pain killers in advance of coming along and that the appt could take up to 2 hours so it sounds like once you've had the ultra sound if they decide you need anything else then they'll do it when you're in.

Good. I think my one stop shop says 5-6 hours but at least you don't have to keep going back, as happens elsewhere. It was a reassuring experience as you know they are so specialist and there is other expertise they can call in easily.

You may be able to see the referral on your NHS app.

@MsMartini I'm in Scotland, we don't have an app yet, supposedly being rolled out later this year but we'll see!

The trouble with a one stop shop is there is no option for a GA. Some women are absolutely fine with a hysteroscopy but for some it's unbearable. The one stop shop takes all choice away.