What should you know about regular periods after menopause?

Menopause is reached after twelve months without a menstrual period. After that point, bleeding or spotting is postmenopausal bleeding, even if it is light or happens once. Vaginal dryness and thinning tissues can cause bleeding, as can polyps, hormone medicines, infection or changes in the womb lining.

Pelvic Organ Prolapse may cause rubbing or tissue irritation, but it does not explain every episode. Bleeding can sometimes be linked to a problem that needs early treatment, so do not assume it is simply a return of periods. The amount of blood does not reliably show the cause.

Contact your GP, gynaecology service or menopause clinician and describe the date, amount, colour and number of episodes. Mention pelvic pain, discharge, urinary symptoms, medicines, hormone therapy and any history of cervical or womb problems. The assessment may include an examination, ultrasound or a sample from the womb lining, depending on your symptoms.

Keep a simple record and use a pad if bleeding returns. Do not stop prescribed hormone treatment without advice; ask whether the timing or type of treatment could contribute and what adjustment, if any, is appropriate.

Seek urgent care for heavy bleeding, clots with weakness, fainting, severe pelvic pain, fever or feeling acutely unwell. Contact a clinician promptly for any new bleeding, repeated spotting or bleeding after sex. Vaginal dryness can cause irritation, but persistent bleeding still needs a proper examination.

Ask: Does this count as postmenopausal bleeding? What examinations or tests do I need? Could my medicines or hormone therapy contribute? What should I do if bleeding happens again? Which symptoms would need emergency help?