Period during menopause: what to know

Menopause is reached after the menstrual periods have stopped for twelve months. Before that point, the menopause transition can make ovulation unpredictable, so the gap between periods and the amount of bleeding may vary. Hot flushes, night sweats, mood changes, vaginal dryness, and low sex drive may occur alongside cycle changes. Bleeding after menopause is different: it may come from thinning vaginal or uterine tissue, polyps, medication effects, or another condition. Pelvic organ prolapse can also cause pressure or bleeding from irritated tissue, so the source should be checked rather than assumed.

Record dates, flow, clots, pain, and any bleeding after sex. Arrange a gynaecology appointment if periods become unusually heavy, frequent, prolonged, or return after a full year without bleeding. Tell the clinician about medicines, contraception, hormone treatment, and other symptoms. They may examine the vagina and cervix and arrange tests to identify where the blood is coming from. Do not self-treat recurrent bleeding with hormones or supplements without advice.

Seek urgent help for bleeding that is heavy or rapidly increasing, severe pelvic pain, fainting, profound weakness, or breathlessness. Contact a clinician promptly for any postmenopausal bleeding, even if it is only spotting or happens once. Urgency is based on the amount of bleeding and accompanying symptoms, not on whether bleeding is common during the menopause transition.

Ask whether your bleeding fits the menopause transition, whether an examination or scan is appropriate, how medicines may affect it, and which symptoms should trigger urgent review.