Menstrual period after menopause: what to know

Menopause is reached after periods have been absent for a sustained period. Bleeding afterward may come from thinning and irritation of the vaginal or womb lining, a cervical or womb polyp, infection, or another gynaecological condition. Pelvic organ prolapse can sometimes cause irritation or bleeding. Hormone medicines and some other treatments can also affect bleeding.

Bleeding is often not a period because ovulation and the regular menstrual cycle have ended. It can be pink, brown, or red, and may appear as spotting or a heavier flow. The cause cannot be identified reliably from colour or amount, and bleeding should not be dismissed because it is small or happens once.

Contact a doctor or gynaecology service and describe when the bleeding began, how much there was, whether it followed sex, and whether you have pain, discharge, urinary symptoms, or dizziness. Mention hormone therapy, vaginal products, blood thinners, and any previous cervical or womb problems.

Assessment may include an examination and tests chosen for your situation, such as a cervical check, ultrasound, or sampling of the womb lining. Do not insert products into the vagina before an appointment unless a clinician has advised them. Continue prescribed medicines unless the prescriber tells you otherwise.

Seek urgent help if bleeding is heavy or rapidly increasing, you feel faint or weak, have severe pelvic pain, fever, or shortness of breath. Emergency symptoms matter regardless of whether the bleeding looks like a familiar period.

What could explain this bleeding in my circumstances? Which examination or test do I need, and how soon? Could my medicines or vaginal symptoms be contributing? What amount of bleeding or pain should prompt emergency care?