St Mary's Launches Service To Support Patients With Postmenopausal Bleeding

Isle of Wight NHS Trust is piloting a new service to support patients experiencing postmenopausal bleeding following Hormone Replacement Therapy (HRT).

The service offers faster, more efficient testing with the aim of reducing unnecessary invasive procedures.

There has been a significant rise in the use of HRT in recent years, which has been accompanied by an increase in reports of unexpected bleeding.

This has led to patients being referred for an investigation of possible cancer, although this is less likely in those on HRT than to those who have bleeding when not on HRT.

Patients who experience postmenopausal bleeding after HRT can now be referred directly by their GP to St Mary’s Hospital for a transvaginal ultrasound scan (TVS).

A direct referral to the service helps to diagnose the cause of bleeding sooner and rule out potentially serious conditions such as endometrial (womb) cancer.

Approximately one-third of those referred for further investigation into postmenopausal bleeding do not require an invasive procedure.

For those whose ultrasound indicates a thickened womb lining, a follow-up hysteroscopy will be offered.

Mr Steve Parker, Medical Director at St Mary’s Hospital said:

“This new pathway allows us to provide direct access to diagnostic testing, offering peace of mind for patients at low risk and ensuring we prioritise investigations for those who may be at increased risk of endometrial cancer.

“As a result of the new pathway, the average waiting time from GP referral to diagnosis has been reduced significantly which is improving patient experience and reducing anxiety for many.”

The transvaginal ultrasound scan (TVS) is performed at the new Outpatients and Community Diagnostic Centre at St Mary’s Hospital, which provides faster access to key diagnostic tests, scans, and checks.

The centre has been open for six months and plays a vital role in improving outcomes for people with long-term conditions, including cancer, stroke, and cardiovascular disease.

Louise from Sandown was recently referred by her GP for a scan as she was experiencing symptoms. 

Louise said:

“I was seen very quicky and treated with the utmost sensitivity. I didn’t feel embarrassed or uncomfortable given the nature of the examination.

“I didn’t realise how uptight I had become over it all. I was able to be reassured there and then and I felt like a weight have been lifted.

"I also had an explanation as to what had caused the symptoms which was reassuring and has made me feel that, should they reoccur, not to necessarily jump to the worst conclusion.”

The new diagnostic pathway was developed in collaboration with the Wessex Cancer Alliance following a successful pilot scheme in Dorset.

Kelly Spiller, Head of Pathways, Improvement and Performance at Wessex Cancer Alliance said:

“We are delighted to see this new diagnostic pathway launching on the Isle of Wight, providing faster and more appropriate diagnostic testing for those who need it.

"One of the aims in our five-year strategy for cancer, is to improve the number of appropriate diagnostic tests that can be accessed and to bring care closer to home via Community Diagnostic Centres. Pathways like this, are helping us to achieve that aim."

Since its launch in March 2025, over 35 women have benefited from the new diagnostic pathway.