Any vaginal bleeding after menopause could be a symptom of uterine cancer and should be taken seriously. Uterine cancer often develops later in life, and there is no routine screening for it.

People who have been through menopause have an increased risk of several reproductive cancers. Uterine cancer (also called endometrial cancer) typically presents with vaginal bleeding. Any vaginal bleeding after menopause, even very small amounts, is a cause for concern.

Uterine cancer is the most common type of cancer that affects the female reproductive system. It’s also the fourth most common cancer among females in developed countries.

Educating yourself about the risk factors and symptoms of uterine cancer after menopause can help you know when to take action.

The most common symptom of uterine cancer is vaginal bleeding. The bleeding may look like your period, like spotting, or like discharge. It often starts as watery streaks of blood and gradually becomes darker.

Research from 2018 found that 90% of people with uterine cancer experienced postmenopausal bleeding.

Signs and symptoms of uterine cancer after menopause may include:

  • vaginal bleeding or bloody discharge
  • pelvic pain
  • pain with urination
  • pain during sex
  • pain or weakness in your lower abdomen, back, or legs
  • an enlarged uterus
  • unexplained weight loss

All postmenopausal bleeding is considered abnormal. Talk with a doctor if you experience vaginal bleeding after menopause, especially if it’s combined with any other symptoms.

Uterine cancer may not show signs or symptoms until it reaches more advanced stages. While early detection of uterine cancer helps improve your chances of successful treatment, it is not always possible.

There are currently no routine screening tests for people with an average risk of developing uterine cancer. This means there are no tests, such as mammograms and Pap smears (which screen for breast and cervical cancer), to check for uterine cancer in people with no symptoms.

The best way to identify uterine cancer at an early stage is to talk with a doctor about any symptoms you experience, such as bleeding, spotting, and pain.

You can also talk with a doctor about your individual risk factors.

Postmenopausal bleeding may be related to a variety of factors, such as:

  • fluctuating estrogen levels
  • inflammation and thinning of the vaginal or endometrial lining
  • cervical or endometrial polyps (noncancerous growths)
  • thickening of the endometrial lining

Even though bleeding after menopause is the most common symptom of uterine cancer, it’s more likely to be a symptom of something else entirely. That’s why it’s important to work with your doctor to discuss your health as a whole.

Certain factors can increase your risk of developing uterine cancer, including:

  • age over 50
  • family history
  • obesity
  • polycystic ovary syndrome
  • type 2 diabetes
  • history of breast or ovarian cancer
  • menstruation beginning before age 12
  • no history of pregnancy
  • certain medications and treatments, including tamoxifen for breast cancer, certain types of birth control, certain types of estrogen replacement, or radiation therapy to your pelvis
  • certain inherited diseases, including Lynch syndrome and hereditary nonpolyposis colorectal cancer

Race can also be a factor — for example, Black people may have a greater risk of uterine cancer than white people, partially as a result of healthcare inequities.

However, many people who have these risk factors never develop uterine cancer. And some people who receive a uterine cancer diagnosis don’t have any known risk factors.

The following exams and tests may help doctors diagnose uterine cancer:

  • medical history
  • physical exam
  • blood work
  • ultrasound
  • biopsy of uterine tissue

If your doctor suspects advanced uterine cancer, they may also check to see whether the cancer has spread to other areas of your body. This may involve additional testing, such as:

  • X-ray (to check your lungs)
  • CT scan (to check other organs)
  • MRI (to check your brain and spinal cord)
  • PET scan (to check for small collections of cancer cells throughout your body)
  • cystoscopy (to check your bladder)
  • protoscopy (to check your rectum)

Not everyone will undergo the same tests to diagnose uterine cancer. Your doctor will make recommendations based on your specific symptoms, risk factors, and health history.

If you experience any vaginal bleeding after menopause or any other unusual symptoms, talk with your doctor. Together, you can decide whether you should go through diagnostic testing for uterine cancer.

It’s important to get to the bottom of what’s causing your symptoms in order to determine the best possible next steps.

Talk with your doctor if you experience any vaginal bleeding after menopause or any other unusual symptoms. These symptoms could indicate uterine cancer.

Catching uterine cancer early can improve your chances of successful treatment.