post menopause spotting - normal?

Dx in Jan 2005. WLE followed by mx. Started Tamox April 2005 then Zoladex June 2005. 2 yrs Zoladex then had 3 periods after it had finished - 1st 14 mths after, then 5 mths, then 3 mths after that. So last period was April 2009 - 18mths ago. Reached 5 year landmark this year. Saw onc in June and had blood test to confirm menopause status. Both oestrogen and progesterone low so now post menopausal and changed from Tamoxifen to Femara (will be for 3 yrs).

I had some spotting overnight and was wondering if this is normal. 'Scuse the graphic description but it was a dark browny colour. Should I be concerned or only if there’s more blood and it’s bright red?



My last period was 2 weeks prior to starting chemo in Nov 2006. I was confirmed as post menopausal the following year about 3 months after finishing Taxotere (I was on Herceptin until April 2008). I was put on topical oestrogen pessaries to sort out a few issues like vaginal atrophy, then about June last year I had a slight bleed which was accompanied by a period pain. You are advised to report any post meno bleeding to your GP to get it checked out and the woman GP I saw said she had to refer me.

I was referred to a post meno bleed clinic at the local hospital where I had an internal ultrasound. They couldn’t take a biopsy as I have scar tissue from laser treatment to my cervix over 20 years ago and it would involve having to give me a general anaesthetic. However, the gynaecologist said everything looked fine. What she explained to me is that once you have gone through the menopause one or both of your ovaries can try to fire up from time to time, hence the slight bleed. I was also advised to stop the pessaries, but I was only using half the dose anyway.

She sent me a letter explaining this - since then I’ve had another very slight bit of spotting lasting a couple of days. I’d say just see your GP for peace of mind. My experience was the same as you - it was like the dark browny coloured discharge you get in the last day of a period. We have had one or two threads about this before as other ladies have had this happen.

You should get it checked out. I had exactly the same bleeding for a few days after about 4 years of Tamoxifen. This turned out to be caused by a harmless polyp that had grown in the womb and even slightly out of the cervix (sorry for the details - it was a bit sci fi!).
Tamoxifen and other drugs often cause womb thickening and this is a common problem, but needs looking at. I was silly as once the bleeding stopped I just forgot about it and only mentioned it months later, in answer to a routine question from my onc.
best wishes

Hi fantan,

I had this too and, as already said, you need to see your GP who will refer you to a post-menopausal bleeding clinic. They review you thoroughly and, to be honest, the whole procedure was no worse than having to have a smear test done. Mine was fine but they did emphasise that ANY post-menopausal bleeding should always be investigated promptly.

Try not to worry. I ruined my annual holiday worrying over what turned out to be nothing.

Nicola x

I found out through seeing the post meno bleed clinic that I had 2 fibroids, but the gynaecologist said they were so tiny there was nothing to worry about. They also blood tested me again just to make sure I was actually post meno, it was just to check whether things were maybe starting up again. However, as I am late 40s I wasn’t expecting this. TBH, I find not having periods is a relief. I was perimenopausal at the time of my diagnosis and they had become an absolute nuisance, very heavy and uncomfortable.

any post menopausal bleeding needs investigated… it could well be normal but you need to be checked to make sure xx

Dear All

Thank you so much for your replies. Went away for the weekend so have only just logged on. As it turned out the bleeding continued over the weekend and became heavier so I think I’ve had a period, but am going to see the onc next week so will have the opportunity to have a chat about it.

Thanks again