Continuous bleeding during menopause: what to know

During the menopause transition, hormone changes can make ovulation and the lining of the womb unpredictable. Bleeding may become prolonged, closer together, heavier or separated by spotting. Other explanations include fibroids, polyps, infection, thyroid problems, medicines or pregnancy if pregnancy remains possible. Bleeding that continues after periods have stopped has a different significance and also needs review.

A clinician may check your blood count for anaemia, examine the pelvis, and arrange imaging or a womb-lining sample depending on your pattern and risk factors. Keep a record of pad or tampon use, clots, pain and fatigue.

Book a prompt appointment rather than trying to manage persistent bleeding alone. Tell the clinician about contraception, hormone therapy, blood-thinning medicines, pregnancy possibility, dizziness and breathlessness. Rest, drink fluids and use products that let you monitor the amount. Do not start hormone medicine or stop prescribed treatment without medical guidance.

Seek urgent help if bleeding is very heavy, you feel faint, have chest pain, shortness of breath, severe abdominal or pelvic pain, fever, or cannot keep fluids down. Continuous bleeding with marked tiredness or paleness may signal anaemia and should be reported promptly.

Ask whether you need a blood count, pelvic examination, ultrasound or lining sample; what treatment could control the bleeding; and what change should trigger emergency care.