Some forms of menopause hormone therapy may cause monthly bleeding. These include cyclic hormone therapy medicines that have both estrogen and progestin. Cyclic means you take the estrogen daily and the progestin for 10 to 14 days each month. Progestin helps protect people who have a uterus from endometrial cancer, which is cancer of the lining of the uterus.

Menopause hormone therapy can result in light bleeding or bleeding that's as heavy as a typical period. Often, the bleeding stops within six months. But if your bleeding concerns you, talk with your healthcare professional.

Other causes of bleeding after menopause can include:

• Thinning of the tissue lining the vagina and uterus due to less estrogen.
• Growths on the inner wall of the uterus, called uterine polyps.
• Infections of the uterus, such as endometritis or cervicitis.
• Growth of the lining of the uterus that is not typical, called endometrial hyperplasia.
• Cancer of the lining of the uterus, called endometrial cancer.

Your healthcare professional may ask about your medical history, do a physical exam, and order lab tests or a procedure to diagnose the cause of your bleeding after menopause.

Nov. 26, 2025

Original article: https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/hormone-replacement-therapy/faq-20058499