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If you’ve reached menopause, you’ve been without a period for at least a year. You probably thought that you were off the hook for vaginal bleeding. But maybe you’ve noticed some bleeding; whether it is spotting or a heavier flow, you’re likely wondering what could be causing it.

There are a number of different conditions that can cause bleeding after menopause. Some conditions are harmless and can self-resolve. Others can be more serious and may require medical treatment. It is important to see your healthcare professional if you’re experiencing any signs of postmenopausal bleeding so that you can be evaluated for some of the more serious conditions.

With that in mind, let’s explore some of the reasons that you may be experiencing postmenopausal bleeding.

Vaginal Dryness

As we age, our vaginas do not lubricate as well as they once did. This can cause activities like sexual intercourse to irritate your vagina and cause bleeding.

Uterine Polyps

Uterine polyps are benign, meaning non-cancerous, growths in the uterus. As these polyps grow, they can press on the surrounding uterine tissue, causing bleeding.


Infections of the cervix or endometrium can cause reddening and enlargement of the tissues. Infections of these areas can also cause oozing or bleeding, similarly to an infection in other parts of your body.

Hormone replacement therapy

During hormone replacement therapy you receive hormone medications to help reduce menopausal symptoms. These hormones can stimulate your uterus similarly to how your uterus was stimulated during your menstrual cycle in your fertile years. Bleeding is common during the first few months of hormone replacement therapy.

Endometrial Hyperplasia

Endometrial hyperplasia is a rare condition where the endometrial lining (the outside layer of tissue in your uterus) is abnormally thick.


Cancers can occur in your vagina, cervix, or uterus. They can all cause bleeding, often from the cancer cells causing your tissues to thicken, and these thickened tissues then shed and bleed.

It is common to have irregular bleeding leading up to menopause, but once you’ve reached menopause and haven’t had a period in a year, it is not normal to be experiencing vaginal bleeding. Consult your healthcare professional to identify the cause of your bleeding, and work with your healthcare professional to create a treatment plan if needed.


  1. “Postmenopausal Bleeding” Cleveland Clinic, Cleveland Clinic. 26 April 2021.
  2. Goodman, Annekathryn. “Approach to the patient with postmenopausal uterine bleeding”. 13 February 2023. Up to date, Up to date.