Getting a period after menopause: what to know

Menopause is reached after twelve months without a menstrual period. Bleeding afterwards is called postmenopausal bleeding, not a returning period. It may come from thinning or irritation of the vaginal or womb lining, polyps, hormone treatment, infection, or other conditions. Most causes are treatable, but some need prompt investigation.

A clinician may ask when the bleeding started, how much there was, whether it followed sex, and whether you use hormone therapy or medicines that affect bleeding. Assessment can include an examination, ultrasound and sometimes a sample from the womb lining.

Arrange a medical appointment as soon as you notice bleeding, spotting or pink, brown or blood-stained discharge after menopause. Note the colour, amount, timing and any pain, and bring a list of medicines and hormone products. Do not assume the bleeding is caused by vaginal dryness or a treatment without an examination.

Continue prescribed medicines unless your clinician tells you otherwise. If you use hormone therapy, ask how the bleeding fits with your regimen and whether it needs review.

Seek urgent help for heavy bleeding, dizziness or fainting, severe pelvic pain, fever, or weakness that is getting worse. Contact a clinician promptly for any recurrent bleeding, bleeding after sex, or discharge with an unpleasant smell.

Ask what may be causing the bleeding, which examinations or scans you need, whether your medicines could contribute, and when results will be available. Ask what changes should prompt urgent review.