Menopause and prolonged bleeding

As menopause approaches, ovulation and the uterine lining can become less predictable, leading to bleeding that is later, earlier, heavier, lighter, or longer than usual. Fibroids, polyps, thyroid problems, medicines, pregnancy-related causes, infection, and changes in the lining can also cause prolonged bleeding. Vaginal dryness may cause light bleeding after friction, but it does not account for every bleeding pattern. After periods have stopped, any vaginal bleeding needs assessment rather than being labelled a late period.

Record when bleeding began, how often you change pads or tampons, whether clots or pain are present, and any medicines or hormones you use. If pregnancy is possible, mention this promptly. Arrange an appointment with a clinician; assessment may include a history, examination, pregnancy testing when relevant, blood tests, or imaging chosen for your situation. Avoid aspirin unless it has been prescribed, because it can increase bleeding.

Seek urgent help if bleeding is heavy enough to make you feel faint, causes severe weakness, comes with severe pelvic pain, or occurs with shortness of breath, chest pain, or collapse. Prompt assessment is also needed for bleeding after sex, repeated bleeding after menopause, fever, foul-smelling discharge, or new pelvic pressure. A pelvic organ prolapse can cause pressure and bulging symptoms, but prolonged bleeding still requires its own evaluation.

What could be causing the duration or amount of bleeding? Do I need blood tests, imaging, or an examination of the uterine lining? How should I manage symptoms while waiting?