Restarting menstruation after menopause

Any vaginal bleeding after menopause should be assessed, even if it is light, brief, or happens only once. Menopause is reached after twelve months without a period, so bleeding afterward is not considered a normal menstrual cycle.

The cause may be thinning or irritation of the vaginal or womb lining, a polyp, hormone treatment, or another gynaecological condition. Less commonly, bleeding can be linked with cancer of the womb or cervix. The symptom does not identify the cause by itself. Other menopause features, such as hot flushes, night sweats, vaginal dryness, mood changes, or low sex drive, do not explain away new bleeding. Menopause can also involve pelvic changes such as pelvic organ prolapse, but a clinician needs to examine you rather than assume the reason.

Arrange an appointment with a GP or gynaecology clinician. Record when the bleeding started, how much there was, whether it followed sex, and any pain or unusual discharge. Bring a list of medicines, including hormone therapy and blood thinners. Assessment may include an examination, an ultrasound, or a small sample from the womb lining, depending on your symptoms and history. Do not stop prescribed treatment without medical advice.

Seek urgent medical help if bleeding is heavy or increasing, you feel faint or weak, have severe pelvic pain, develop fever, or notice foul-smelling discharge. These signs can indicate significant blood loss or infection and need prompt assessment.

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