Menopause and long periods with bleeding

During the menopause transition, ovulation may become irregular. The womb lining can then build and shed unevenly, causing a period that lasts longer than your usual pattern or changes from spotting to a heavier flow. Fibroids, polyps, adenomyosis, thyroid problems, pregnancy, infection, medicines, and changes in the cervix or womb can also cause prolonged bleeding.

Long-lasting bleeding may leave you tired, short of breath, dizzy, or pale if it contributes to anaemia. Those symptoms need attention even when the bleeding is not dramatic. Bleeding after twelve months without periods is postmenopausal bleeding and should always be assessed.

Note the first and last day, how often you change menstrual products, clots, pain, bleeding after sex, and symptoms such as fatigue or breathlessness. Contact a clinician if bleeding lasts longer than expected for you, keeps returning, or is affecting daily activities. Bring your medicines and contraception details. Your clinician may discuss an examination, blood tests, or imaging based on your history.

Seek urgent medical help if bleeding is soaking through products quickly, continues with faintness or marked weakness, or occurs with severe pelvic pain. Get prompt advice for bleeding after menopause, fever, foul-smelling discharge, or new breathlessness. Emergency symptoms should not be managed by waiting for the bleeding to settle.

Ask whether you may have anaemia, what might explain the duration, which tests are appropriate, and which treatment options could reduce bleeding safely for you.