If bleeding occurs again after one month of menopause, the pregnancy should be determined by monitoring the blood or urine HCG. If pregnant, further ultrasonography is needed to determine if the pregnancy is normal intrauterine and to rule out ectopic pregnancy. It is also necessary to rule out incomplete or complete miscarriage, the possibility of a vacuolated pregnancy, and the possibility of a preterm miscarriage. If it is not a pregnancy, the decision to follow up will be based on the thickness of the endometrium as indicated by ultrasound. If the endometrium is thin, it can be temporarily treated conservatively with hemostatic and anti-inflammatory drugs. If the endometrium is thicker and there is not much vaginal bleeding, retreating bleeding with progesterone is needed.