Do periods stop after menopause?

Menopause is reached after twelve months without a menstrual period, when no other cause explains the gap. The transition before it, called perimenopause, can bring skipped periods, changing flow, and longer or shorter cycles. Symptoms such as hot flushes, night sweats, vaginal dryness, and mood changes may occur during this transition, but not everyone experiences them.

Once menopause has occurred, menstrual bleeding should not restart. Bleeding may come from the vagina, cervix, uterus, or nearby tissues, so its source cannot be identified from appearance alone.

Keep a note of the date, amount, colour, and whether the blood appeared after sex or with pain. If you are still in perimenopause, irregular periods can be part of the transition, although pregnancy and other causes may need consideration. A clinician can review medicines, contraception, hormone treatment, and your medical history before deciding whether an examination or test is needed.

Arrange medical assessment for any vaginal bleeding after menopause, even if it happens once or looks like spotting. Seek urgent help if bleeding is heavy, you feel faint or weak, or it occurs with severe pelvic pain. Do not assume bleeding is a late period; postmenopausal bleeding has several possible causes, many of which are treatable.

Ask what may be causing the bleeding, whether your medicines or hormone treatment could contribute, and which examination or scan would clarify the source. You can also ask how to manage symptoms such as vaginal dryness or sleep disruption.