Period after two years of menopause

After menopause, the lining of the womb is no longer expected to shed as a monthly period. A bleed years later can be caused by fragile or thinning tissues, a polyp, hormone therapy or another pelvic condition. It can also be an early sign of cancer. These possibilities cannot be sorted out by the colour or amount of blood alone.

Write down when it happened, how long it lasted, and whether it followed intercourse. Note pelvic pressure, pain, discharge or urinary changes, and bring your medication list to the appointment.

Arrange a prompt appointment with a gynaecologist or qualified clinician. They may ask about your menopause history and examine the vagina and cervix; further assessment can include imaging or sampling the womb lining. Continue prescribed treatment until the prescriber advises otherwise. Use a pad if bleeding returns so you can describe it accurately.

Seek urgent help for heavy or continuing bleeding, severe abdominal or pelvic pain, fainting, dizziness, fever or sudden weakness. If the episode was brief and you feel well, still arrange a review soon. The long gap since your last period makes evaluation appropriate; it does not identify the cause.

Ask what could explain the bleeding, which examination or tests are suitable, and when results will be available. Ask how to contact the service if bleeding or pain returns.