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[Michelle44]

After orgasm last night I have suddenly started spotting. Slight cramping too. Sex at the moment is sporadic and not always penetrative. Is this normal? Been post menopause and on EVORIL CONTI HRT for 2 years. Never had any spotting before.

[CLKD]

Morning.  Spotting may be caused by vaginal atrophy : as oestrogen levels drop the body may become dry; inside and out.  This may cause the vaginal tissues to be very thin = bleeding on contact.

How is it this morning?  Is it on the tissue after wiping ?  Keep an eye on the situation and if this continues check in with the Nurse Practitioner in the New Year.

[Michelle44]

Thank you for your response ❤️ It’s actually better today? The cramping has stopped and the spotting has too. There was a little in my underwear and when I wiped but it seems ok now? Kind of, putting it down to ‘post menopause sex life now’ 🤦🏼‍♀️ I’ll monitor it. So reluctant to go for smear tests too, now. So painful. But thanks again for responding. Xx

[bombsh3ll]

This is almost certainly vaginal atrophy especially as intercourse and smears are painful too.

If you don't want or cannot access a higher dose of systemic estrogen then why have you no vaginal estrogen?

You don't need to wait, just request a prescription from your GP today for either cream or pessaries.

Or you can just go into boots and buy some.

I wouldn't mention the bleeding at this point unless it continues after treatment of vaginal atrophy as this could jeopardise your prescription and lead to invasive and almost always negative investigations.

But cervical screening is still important and you can now get a self taken swab in England instead of a speculum examination so no excuse!

[sheila99]

I second this. Va only gets worse if untreated and you really don't have to put up with it.