In women who have passed the menopause (the change of life) and who have stopped taking HRT any vaginal blood loss that lasts for more than a month after stopping the hormones is abnormal and can be a sign of either a cancer of the cervix (the neck of the womb) or cancer of the lining of the womb itself (which is also called an endometrial cancer). There are other reasons for bleeding that goes on for more than a few weeks after stopping HRT but it is important to make sure that the problem is not due to a cervical or endometrial cancer, especially as, if they are detected at an early stage, these cancers are very curable.

So vaginal bleeding that is going on for more than a few weeks after finishing her HRT is not something your mother should ignore and just hope will go away on its own - she should go and see her family doctor (GP) for a check up.

The Department of Health has recently given guidelines to general practitioners about women who come to them because of having bleeding after stopping HRT. These say that if you have bleeding from the vagina that goes on for more than four weeks after stopping HRT then the GP should arrange an urgent appointment with a hospital specialist (a consultant gynaecologist).

Normally the 'urgent' hospital appointment means that the specialist will see your mother within two weeks.

When the gynaecologist sees your mother he or she will take her full medical history and carry out a careful physical examination. The specialist will probably do other tests which may include:

• looking directly at the cervix and vagina using a device called a speculum, which gently separates the walls of the vagina and holds them apart
• colposcopy, where the doctor again uses a speculum but then looks at the cervix through a small microscope to carefully examine its surface and take tiny samples (biopsies) of any abnormal looking areas
• hysteroscopy, in which a mini-telescope is inserted into the womb (the uterus) which lets the doctor look at the lining of the womb and take samples (biopsies) of any abnormal looking areas
• an ultrasound scan where a scanner, rather like a small microphone is gently rubbed over the outside of the tummy and, by using sound waves, makes up pictures of the organs inside
• a scan of the pelvis, either a CT-scan or an MRI scan.

If these tests do show that there is a cancer on the cervix or on the lining of the womb then further treatment might involve an operation to take the growth away or it may mean some radiotherapy, hormone therapy or chemotherapy, depending on the exact type of the cancer and its size.

Cancers of the cervix and the lining of the womb are very curable, especially if they are caught early, so if your mother has noticed bleeding from her vagina for more than four weeks after stopping her HRT tell her not to delay and to go and see her doctor.