AimsThe incidence of postmenopausal bleeding (PMB) has been increasing over the past years. Little is known about the risk of PMB after COVID‐19 vaccination. Our study aimed to investigate this based on routine general practitioner (GP) healthcare data from the Netherlands.MethodsA retrospective self‐controlled cohort study was performed, which included women aged ≥50 years who received at least 1 COVID‐19 vaccination in 2021 and were registered in the GP databases of Nivel (the Nivel Primary Care Database, Nivel‐PCD) or PHARMO by 1 January 2021. GP consultations for PMB in the exposed period (28 days after each COVID‐19 vaccination) were compared with the nonexposed period (all‐time outside the exposed period). Incidence rate ratios (IRRs) were calculated using Poisson regression, adjusting for SARS‐CoV‐2 infection during the study follow‐up period.ResultsA total of 692 760 COVID‐19 vaccinated women aged ≥50 years were included. No increased GP consultations for PMB was observed for all COVID‐19 vaccines together, as well as when stratifying the results by vaccine type (mRNA vs. vector) and vaccine brand (Pfizer/BioNTech, Moderna, AstraZeneca, Johnson & Johnson). After the second Moderna dose an adjusted IRR of 1.47 (95% confidence interval: 0.93–2.32) was observed and after the third Pfizer/BioNTech dose an adjusted IRR of 1.33 (95% confidence interval: 0.92–1.93); however, these results were not statistically significant.ConclusionNo increased number of GP consultations for PMB in primary care was observed after COVID‐19 vaccination in general, nor for any of the COVID‐19 vaccine brands, vaccine doses or potential risk groups.