Periods after menopause after one year

Menopause is reached after twelve months without a menstrual period. Later spotting or bleeding may come from vaginal dryness, irritation, hormone treatment, polyps, infection, or pelvic organ prolapse. Less commonly, it can be an early sign of a condition affecting the womb or its lining, so the amount of bleeding does not determine whether it matters. Hot flushes, night sweats, mood changes, or low sex drive may continue around menopause, but they do not explain away new bleeding.

Contact a doctor or gynaecology service promptly, even if the bleeding is pink, brown, light, or has stopped. Record the date, amount, colour, pain, discharge, medicines, and whether bleeding followed sex. Assessment may include an examination, ultrasound, and sometimes a sample of the uterine lining. Do not delay review while waiting to see if it happens again.

Seek urgent help for heavy bleeding, severe pelvic pain, faintness, weakness, fever, or foul-smelling discharge. Otherwise, arrange prompt routine assessment for any bleeding after menopause, including a single episode of spotting.

Could vaginal dryness, prolapse, or my medicines contribute to this bleeding? Which tests are appropriate? What symptoms should make me seek urgent help?