Getting a period after menopause: what to know

Bleeding after menopause can come from thinning or irritation of vaginal tissue, cervical or womb polyps, hormone treatment, infection, pelvic organ prolapse or changes in the womb lining. It can also be linked to womb cancer, so the cause should not be assumed from the amount or colour of blood. Menopause symptoms such as hot flushes, night sweats, vaginal dryness or mood changes do not explain away new bleeding.

Contact a GP or gynaecology service and describe when the bleeding happened, how much there was, whether it followed sex, and any hormone medicines or blood thinners. Bring a medication list. Assessment may involve an examination, ultrasound or a sample from the womb lining. Do not restart or change hormone treatment without advice. Note further episodes while waiting for review.

Seek urgent care if bleeding is heavy or persistent, you feel faint or weak, have severe pelvic pain, fever, or trouble passing urine. Emergency help is needed for collapse, severe pain or breathlessness. Even a single small episode after a long time without periods should be reported promptly, although it may have a non-cancerous cause.

Ask what examinations are appropriate, whether your medicines could contribute, whether the womb lining needs sampling, and how you will receive results. Mention pelvic pressure, vaginal dryness, pain or changes in discharge.