Hello, Thank you for your query. Before menopause, our ovaries release hormones that act on the endometrium (the inner lining of the uterus) which cause it to thicken and undergo cyclical changes resulting in menstruation. After menopause, these hormones are no longer present and hence no menstruation. Hormone replacement therapy (HRT) can affect the endometrium and cause it to thicken/develop. When this endometrium has reached a certain thickness, it can be shed due to sheer weight of it. I recommend : -an OBGYN consult - an ultrasound to check for endometrial thickness and fibroid or even ovarian cysts -readjustment in medications, if necessary. -you may be asked to withdraw or change. The modality of medications if itthe reason for the bleed. -an endometrial tissue sample may need to be examined to check for any abnormal cells. Based on the above a treatment plan can be initiated. I urge you to see medical attention right away. It is not normal to bleed after menopause and the cause must be investigated. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good health