Period after menopause: what it may mean and what to do

Menopause is reached after periods have stopped for a sustained time because ovarian hormone production has changed. Bleeding afterwards may come from thinning or irritation of the vaginal or uterine lining, a polyp, hormone treatment, or another gynaecological condition. Some causes are benign, but bleeding can also be an early sign of cancer, so its appearance alone cannot identify the cause.

Make a note of whether the blood was pink, red or brown, how much you saw, and whether it followed sex. Tell the clinician about hormone therapy, medicines that affect clotting, pelvic pain, discharge or urinary symptoms.

Arrange an appointment with a gynaecologist or another qualified clinician. Assessment may include an examination and, when appropriate, imaging or a sample from the lining of the womb. Do not restart or stop prescribed hormones without advice. Use a pad rather than guessing the amount from toilet paper, and record any further episodes.

Seek urgent medical help if bleeding is heavy or persistent, or if it comes with dizziness, fainting, severe pelvic pain, fever, weakness or shortness of breath. A small spot still warrants a routine appointment; urgency is based on the amount, duration and symptoms, not on whether bleeding is common.

Ask what examinations are appropriate, whether your medicines or hormone treatment could contribute, and when you should expect results. You can also ask what symptoms should prompt earlier contact.