Postmenopausal bleeding: always get it checked
Bleeding that happens 12 months or more after your last period is a different category from the irregular bleeding of perimenopause, and the guidance is unambiguous: report it, every time, regardless of how little there is. The NHS is explicit that this applies even to a single episode of spotting.
Why the bar is "every time," not "if it's a lot"
The NHS's own guidance states plainly: "postmenopausal bleeding is not usually serious, [but] it can be a sign of cancer. Cancer may be easier to treat if it's found early." That second sentence is the entire reason the threshold for reporting it is so low — amount and frequency are not the filter. A single spot of pink discharge gets the same "see a GP" answer as heavier bleeding.
Common causes include thinning and inflammation of the vaginal lining (a normal, treatable effect of lower oestrogen) and cervical or womb polyps, which are usually benign. Less commonly, it can be a sign of a growth that needs treatment. A clinician cannot tell which one applies without an examination — that judgement is not something to make from home, and it isn't something HormoneLog or any tracker is built to make either.
What to record before you call
- The date of the bleeding or spotting.
- How much — spotting, light, or more, and whether it repeated.
- Anything else new around the same time — pelvic pain, unusual discharge, or bleeding specifically after sex.
- Whether you're on HRT, and if so, whether this looks different from any expected withdrawal bleed on a cyclical regimen (see HRT formulations explained for what "expected" can mean on a cyclical regimen — anything outside that pattern still gets reported).
That's the full list. A GP appointment for this is short and focused, and a dated note answers the first two questions before you're asked them.
What happens next
A GP who hears about postmenopausal bleeding refers for further assessment — commonly a transvaginal ultrasound — rather than deciding over the phone. This isn't a sign that anything is necessarily wrong; it's the standard next step for every case, precisely so that the minority that need treatment are caught while it's easiest to treat.
This is general information, not medical advice. HormoneLog is a tracking tool, not a diagnostic device, and cannot tell you whether bleeding is a symptom of a treatable menopausal change or something that needs assessment. If you notice bleeding 12 months or more after your last period, contact a GP — the guidance is to do this regardless of amount, frequency, or how you feel otherwise.
Tracking periods and bleeding in perimenopause. · What "12 months" means, and why menopause is only known in hindsight. · How to log an HRT change.
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About HormoneLog
HormoneLog is an iOS app from Baker Ventures LLC for tracking perimenopause and menopause symptoms and keeping an HRT record: what you took, at what dose, from when, and what changed afterwards. It is built for the appointment, where "it has been bad lately" is worth far less than a dated record of frequency and severity. The app is in development.
HormoneLog is a record-keeping tool. It does not diagnose, does not score you, and makes no claim about symptom relief. The guides on this site link to NICE, the NHS, the Menopause Society and peer-reviewed sources, and say plainly where the evidence is thin. Everything here is free and needs no account.
Questions and answers
What counts as postmenopausal bleeding?
Any vaginal bleeding, spotting, or pink or brown discharge that happens 12 months or more after your last period — even a single episode, and even a very small amount.
Is postmenopausal bleeding usually serious?
No — it is most often caused by thinning of the vaginal lining or benign polyps. But a minority of cases have a more serious cause, which is why the guidance is to get every episode checked rather than to wait and see.
What should I record before I call?
The date, roughly how much (spotting, light, or more), whether it happened once or has repeated, and anything else new — pain, discharge, or bleeding after sex. That's the whole list a clinician needs to triage it.
Can HormoneLog tell me whether bleeding after menopause is serious?
No. HormoneLog records what you log. Postmenopausal bleeding is assessed by a clinician, and the guidance below is to report it promptly regardless of how it looks — not to judge it yourself first.
HormoneLog. “Postmenopausal bleeding: always get it checked.” Baker Ventures LLC, September 8, 2026. https://hormonelog.bakerventuresstudio.com/guides/postmenopausal-bleeding-always-get-it-checked/