Postmenopausal bleeding





Differential diagnosis


Infrequent

Specific differential diagnosis


Age: Onset:

Further management

NICE cancer referral guidelines for endometrial cancer suggest the following:


Refer women using a suspected cancer pathway referral (for an appointment within 2 weeks) for endometrial cancer if they are aged 55 and over with post‑menopausal bleeding (unexplained vaginal bleeding more than 12 months after menstruation has stopped because of the menopause).

Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for endometrial cancer in women aged under 55 with post‑menopausal bleeding.

Consider a direct access ultrasound scan to assess for endometrial cancer in women aged 55 and over with:
  • unexplained symptoms of vaginal discharge who:
    • are presenting with these symptoms for the first time or
    • have thrombocytosis or
    • report haematuria, or
  • visible haematuria and:
    • low haemoglobin levels or
    • thrombocytosis or
    • high blood glucose levels.