Hi Anne_N
![welcomemm :welcomemm:](https://www.menopausematters.co.uk/forum/Smileys/extended/welcomemm.gif)
First - once you start HRT then you don't know when you are post-menopausal. This can be assumed approximately on the basis of age, what your periods were doing before you started HRT, and your bleeding pattern, but you can't say definitely.
Therefore the bleed you have had may or may not be a post-menopausal bleed, but in any case because you are on continuous combined HRT is not actually classed as such.
Having said that, any bleed after a long time without - which includes being settled on continuous combined HRT for that length of time without a beed - should be investigated just to rule out other causes. This could be due to a late ovulation (after all you are only 54) or it could be that the balance between oestrogen and progestogen is not quite right and that your womb lining has thickened, causing the bleeding. It could be because the levels in your body have changed for some reason. What type/brand of HRT are you taking? Finally it could be due to some problem with your womb lining eg fibroids or polyps etc.
Whatever the reason you should report this to your doctor and you should be referred for a scan - ideally abdominal and vaginal, to determine the thickness of your womb lining.
By the way it is not a worry not to bleed on sequential HRT. This is quite normal for women who may become post-menopausal while still on sequential HRT,. It just means that the particular brand of HRT that you are using is controlling your womb lining to the extent that it doesn;t build up during the two weeks of oestrogen only. This happened to me in my late 50's. I was still on a 28 day cycle and my withdrawal bleeds stopped. The doc said to go onto continuous combined but that didnt suit me so I stayed with a cycle (even though I am mid 60's) so I knew I could safely go onto a longer cycle (with her approval). Some women never bleed on sequential HRT. Unscheduled bleeding is always more of a concern than lack of beeding!
Hope this helps
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Hurdity x