What should you know about monthly bleeding after menopause?

Monthly bleeding after menopause is not a normal period and should be assessed by a clinician, even when the bleeding is light. Bleeding afterwards can come from the vagina, cervix, uterus, or nearby tissue and needs the source clarified.

Dry, fragile vaginal tissue linked with genitourinary syndrome of menopause can bleed after sex or examination. Polyps, endometrial hyperplasia, infection, or medicines can also contribute. Less commonly, bleeding is associated with womb, cervical, or vaginal cancer. The symptom does not establish a diagnosis, but it is a reason for timely evaluation.

Book an appointment and record when bleeding happened, how much there was, whether it followed sex, and whether you have pain or discharge. The clinician may examine the vagina and cervix, review medicines, and arrange ultrasound or other tests of the womb lining. Bring details of hormone therapy or blood-thinning medicines, and do not delay because bleeding stops.

Use urgent care for heavy or rapidly increasing bleeding, dizziness, fainting, severe pelvic pain, fever, or marked weakness. Seek emergency help if you feel unstable. Otherwise, arrange a prompt assessment for any bleeding after menopause, including spotting or pink, brown, or red discharge.

Ask where the bleeding may be coming from, which examination or scan is appropriate, and whether the womb lining needs sampling. Ask how medicines or hormone therapy affect assessment and which changes should make you seek urgent help.