Spotting during menopause: what it can mean

As hormone levels change, periods may become irregular, lighter, or heavier before stopping. Spotting may also come from vaginal dryness or irritation, a polyp, fibroids, infection, or pelvic organ prolapse. Most causes are treatable, but bleeding cannot be explained safely from its appearance alone.

Menopause is reached after a sustained period without a menstrual period. Any new bleeding after that point is called postmenopausal bleeding and needs a clinical review, even when it is only a small amount.

Record the date, colour, amount, whether bleeding followed sex, and any pelvic pain or unusual discharge. Arrange an appointment with a doctor or gynaecology service. They may examine the vagina and cervix and recommend tests such as an ultrasound or a sample of the womb lining, depending on your history. Mention hormone treatment, contraception, blood thinners, and previous abnormal bleeding.

Seek urgent help for bleeding that is heavy or rapidly increasing, severe pelvic pain, fainting, breathlessness, or unusual weakness. Contact a clinician promptly for any bleeding after menopause, repeated spotting, bleeding after sex, or discharge with an unpleasant smell.

Ask what may be causing the spotting, whether you need an examination or ultrasound, how medicines affect the bleeding, and what changes should prompt urgent review.