Post-Menopausal Bleeding. Mr Alan Gillespie answers the FAQs…

Mr Alan Gillespie, Consultant Gynaecologist
Claremont Clinics: Thursday evenings/Friday & Saturday mornings

Mr Gillespie specialises in the management of most gynaecological problems including the diagnosis and treatment of gynaecological pre-cancer and cancer.


What is Post-Menopausal Bleeding? Post-Menopausal Bleeding (PMB) is vaginal bleeding that occurs more than 12 months after your last menstrual period or the menopause.


What is abnormal Peri-Menopausal bleeding? This is irregular bleeding around the time of the menopause. The causes can be similar to PMB.


I have had some vaginal bleeding that sounds similar to this, do I have cancer? Bleeding of this nature is an anxiety provoking symptom that requires prompt investigation. However, there is a good chance that there is an innocent explanation. Only 5% of women with PMB will have cancer of the uterus (womb).


What investigations are required? Investigations will typically include an ultrasound scan, endometrial biopsy (a sample is taken from the lining of the womb) and/or a hysteroscopy. Depending on the situation swabs (to exclude an infection) and a cervical smear may be required.


I have never heard of a hysteroscopy, what is this? A hysteroscope is a small telescope that is introduced via the cervix (neck of the womb) into the cavity of the womb so that the doctor can identify any areas of concern. Usually the procedure can be performed in the consulting suite under local anaesthetic and is well tolerated by patients. Occasionally a general anaesthetic is required if the results of other tests indicate that this is appropriate. Some patients prefer to have the procedure performed under general anaesthetic.


How will the ultrasound scan be performed? The scan typically is performed by placing a probe on the abdomen and another into the vagina. For the abdominal scan the bladder has to be full. The internal scan is usually well tolerated with minimal discomfort.


How quickly can I be seen and reassured? The aim of the service is to see patients concerned about their symptoms as soon as possible and offer prompt reassurance.


What will happen when I attend for an endometrial biopsy or hysteroscopy? After meeting the reception staff in the private consulting area you will see the consultant who will explain the procedure and address any concerns you may have. You will be taken to a separate private room by the nursing staff to get ready for the procedure. After the procedure has been performed you will have a further discussion with the consultant and a follow up plan confirmed.


What happens next? This depends on the results of the investigations. Most patients will be reassured that there is no serious cause for their symptoms. In the small proportion of patients where cancer is identified then surgery will usually follow.


A private consultation with Mr Gillespie is £195 if you don’t have health insurance. To book an appointment, just call our Private Patient Team on 0114 263 2114. You can self-refer to Mr Gillespie if you are paying for yourself. You only need a GP referral letter if you are insured (Mr Gillespie is recognised by all health insurers) and you can see one of our Private GPs quickly for this if you prefer. 

Copyright Alan Gillespie, 2019.

Date: 24/09/2019
By: technical