FEEL WELL • PERIODS

Bleeding around menopause:
when to get it checked.

LAST REVIEWED: 2026-10-25 • By the LatelyWell editorial team • How we write & review

Irregular bleeding is common in perimenopause, so it can be hard to know what is worth a doctor's visit. NHS guidance is clear on a few situations that should always be checked. Here they are in one place.

Why this matters

The NHS says that during perimenopause periods may become irregular, lighter or heavier. That is common, but some changes need checking, because bleeding can occasionally be a sign of a condition that is easier to treat when found early.

1. Any bleeding after menopause

If you have not had a period for more than 12 months and you get any vaginal bleeding, the NHS says this is postmenopausal bleeding and needs to be checked by a GP, even if:

• it has only happened once
• there is only a small amount of blood, spotting, or pink or brown discharge
• you have no other symptoms
• you are not sure it is blood

The NHS says postmenopausal bleeding is not usually serious but can be a sign of cancer, and cancer may be easier to treat if found early.

2. Bleeding that is getting heavier

The NHS advises contacting a GP if you still have periods but your pattern has changed and you are bleeding more, not less, than before. See heavy periods in perimenopause for the NHS signs of heavy bleeding.

3. Bleeding between periods or after sex

The NHS heavy periods guidance advises seeing a GP if you bleed between periods or after sex.

4. Bleeding on HRT that does not settle

The NHS says taking HRT during perimenopause may cause some irregular bleeding or spotting that should settle within 6 months. Talk to your GP if you are still having irregular or heavier bleeding or spotting after 6 months. Read our common questions about HRT.

5. Bleeding with pain or other symptoms

The NHS advises seeing a GP if you have severe period pain, or heavy periods with other symptoms such as pain when peeing, pooing or having sex.

Making the appointment easier

• Write down when bleeding happened, how much, and for how long.
• Note your last period date and whether you use hormonal contraception or HRT.
• Bring a list of your medicines.

Our appointment guide covers this in more detail.

Frequently asked questions

Is spotting after menopause serious?

The NHS says postmenopausal bleeding is not usually serious, but any bleeding, including spotting or pink or brown discharge, should be checked by a GP.

How long after my last period counts as postmenopausal bleeding?

The NHS describes postmenopausal bleeding as any vaginal bleeding when you have not had a period for more than 12 months.

Is irregular bleeding normal when starting HRT?

The NHS says some irregular bleeding or spotting may happen in perimenopause on HRT and should settle within 6 months. See your GP if it continues.

Where to find reliable information

If you want to read further, these organisations publish free, evidence-based information for the public:

• UK: the NHS menopause pages, the NICE menopause guideline and the Women's Health Concern factsheets from the British Menopause Society.
• US: The Menopause Society, ACOG and the National Institute on Aging.
• Australia: Jean Hailes for Women's Health and the Australasian Menopause Society.

Guidance differs a little between countries, and treatment names and availability vary, so check what applies where you live and talk to a clinician about your own situation.

The bottom line

Irregular periods are common in perimenopause, but bleeding after menopause, heavier bleeding, bleeding between periods or after sex, and HRT bleeding that does not settle should all be checked. It is usually not serious, and getting checked is the right call.

Educational information only; not medical advice, diagnosis or treatment. Seek professional care for symptoms that are severe, persistent, worsening or concerning.