Well-womb clinic at Oxford, The Manor Hospital

What is postmenopausal bleeding?

The menopause is when your periods permanently stop. This happens because the follicles (small sacs) that release eggs in your ovaries are no longer active.

Before menopause, it is common to have episodes of irregular bleeding or less frequent periods for several months or years.

If you have any bleeding from the vagina more than 12 months after your periods stop altogether, you need to see your doctor.

Overview of challenges with menopause clinics in the NHS

Investigating post/peri-menopausal bleeding (PMB) in the NHS can be challenging because of resource constraints and other clinical complexities.

Limited resources in terms of staff, equipment, and clinic availability can delay investigations, and long waiting times for transvaginal ultrasounds, hysteroscopies, and biopsy appointments can make getting an early diagnosis more difficult.

Other factors that can impede a diagnosis include:

• Co-morbidities, such as obesity or cardiovascular disease
• Your tolerability for invasive tests like hysteroscopy
• Communication barriers, such as language differences
• Training gaps in recognising PMB’s significance
• Difficulty managing investigations

Addressing these challenges requires investment in resources, enhanced workforce training, and streamlined pathways to ensure timely and equitable care for all women experiencing PMB.

What the Well-womb Clinic offers as a solution

The Manor Hospital (together with Oxford Gynaecology) are delighted to offer a comprehensive, one-stop clinic for investigating post/peri-menopausal bleeding (PMB).

This streamlined service is designed to provide rapid assessment and diagnosis in a single visit, reducing anxiety, and ensuring timely care for women experiencing PMB.

What to expect when you arrive

Upon arrival, we’ll discuss your medical history and conduct a review focusing on symptoms, risk factors, and any other relevant gynaecological factors. This ensures clinicians have a thorough understanding of your condition.

A detailed physical examination

We’ll then conduct a detailed physical examination to assess risk factors, locate any local causes of bleeding (vaginal atrophy or cervical abnormalities), and to identify any palpable pelvic masses.

Following this, patients can receive a transvaginal ultrasound, a key diagnostic tool for assessing the endometrium (the inner lining of the womb). This scan measures the thickness of the womb lining and helps detect structural abnormalities like polyps or fibroids, which could explain the bleeding.

Further evaluation

If further evaluation is required, the well-womb clinic offers same-day hysteroscopy.

This minimally invasive procedure uses a thin telescope to directly visualise the womb cavity. This means we can identify abnormalities such as polyps, pre-cancerous, or cancerous changes.

During this procedure, biopsies can be taken for laboratory analysis, ensuring accurate diagnosis.

A comprehensive screening, all in one place

By integrating an investigation into your medical history, a physical examination, imaging, and hysteroscopy into one appointment, the clinic minimises delays and improves patient convenience.

The Manor’s state-of-the-art facilities combined with Oxford Gynaecology’s experienced team provide high-quality, patient-centred care, enabling efficient diagnosis and management of PMB in a supportive environment.

How to book your appointment

Booking into our one-stop clinic couldn’t be easier. Patients can contact Oxford Gynaecology directly on:

• Telephone: 01865 851105
• Email: admin@oxfordgynaecology.co.uk
• Website enquiry: Oxford Gynaecology

Patients commonly contact us immediately after having concerning symptoms or after having a scan that reveals abnormalities.

If you have had an ultrasound with your GP that has raised concerns, you can contact us directly without returning to see your GP as we know the waiting time can be long and anxious. In our specialist well-womb clinic, we aim to see everyone within 2 working days as our clinics run across the working week.

What should I bring to my appointment?

On the day of your appointment, bring any relevant medical records, a list of medications, and any questions you have.

Our consultants