Bleeding during or after menopause

During the menopause transition, changing hormones can make cycles unpredictable. Bleeding may be lighter, heavier, or separated by longer gaps. Other causes include vaginal dryness, cervical or womb polyps, fibroids, infection, medicines, and pelvic organ prolapse.

If you have gone through menopause and then bleed, the source may be the vagina, cervix, or womb. The amount may be small, but the timing still matters. A clinician may need to check the tissue and the womb lining to identify the cause.

Arrange a medical appointment and describe when your last period occurred, when bleeding began, how long it lasted, and whether it followed sex. Note pain, discharge, urinary changes, or pressure in the pelvis. Bring a list of medicines and hormone treatments. Do not use leftover treatment to stop the bleeding before you have been assessed.

Use emergency services for rapidly heavy bleeding, severe pain, fainting, confusion, breathlessness, or profound weakness. Seek prompt clinical advice for any bleeding after menopause, bleeding that returns, bleeding after sex, or bleeding with new pelvic pressure or offensive discharge.

Ask whether the bleeding fits the menopause transition, which examination or imaging is appropriate, whether medicines could contribute, and what warning signs mean you should return sooner.