Menopause is diagnosed when you no longer have a period for 12 consecutive months.
You may have irregular periods while you transition through perimenopause to menopause, along with other symptoms like hot flashes and trouble sleeping. Once you have gone 12 months without a menstrual cycle, can periods restart after menopause?
Menopause is a natural biological process that typically happens when women are in their 40s or 50s. The average age in the United States is 51.1
Some women also enter menopause following surgery, such as after a hysterectomy that includes removal of the ovaries. Since ovaries produce estrogen, the removal of them can cause a woman to go into menopause immediately—sometimes called surgical menopause.2
The physical and emotional symptoms of menopause are felt in varying degrees by different women, but a common side effect is irregular periods. That can mean periods that skip a month and return, or skip several months and then start on a regular monthly cycle again for a few months. Periods also tend to happen on shorter cycles, so they are closer together.1
The official “diagnosis” of menopause is when you don’t have a period for 12 consecutive months.1
Can Periods Restart After Menopause?
If you have gone 12 months without a period, then your periods should not restart after menopause. Bleeding after menopause is not normal. It’s true that bleeding could be caused by an activity, by an infection or by a thinning of the vaginal or vulvar skin. But it could be a symptom of something more serious.3
Vaginal bleeding that occurs a year or more after your last menstrual period is known as postmenopausal bleeding.4
Postmenopausal vaginal bleeding could be caused by:
- thyroid abnormalities3
- bleeding disorders3
- endometrial or vaginal atrophy—when the lining of the uterus or vagina becomes thin and dry4
- cervicitis or endometritis—an infection or inflammation in the cervix or uterus4
- cancer of the uterus, cervix or vagina5
- hyperplasia, which is the formation of abnormal cells within the lining of the uterus3
- bleeding from other areas, nearby, in the bladder or rectum4
- hormone replacement therapy4
Vaginal bleeding after menopause is a sign of uterine cancer in approximately 10% of women.4 The bleeding may be heavy, but even light spotting is a concern. It’s estimated that postmenopausal bleeding occurs in about 10% of women over 55.4
Diagnosing Postmenopausal Bleeding
It’s important to see a doctor if you have vaginal bleeding after menopause. The doctor will attempt to identify the cause of the bleeding by examining your vagina and cervix; by performing a pap smear to check the cervical cells; by ultrasound; and possibly by biopsy.4
The management or treatment of the bleeding will depend on its cause.4
See A Doctor
It’s important to seek medical attention if you have vaginal bleeding more than a year after your last menstrual period, or more than a year after starting hormone replacement therapy.4 Use our Physician Finder to find a doctor near you with expertise in women’s health, to properly diagnose and treat the postmenopausal bleeding.