
Went Through Menopause, Had Occasional Light Spotting. Now Starting Periods With Cramps. Suggest?

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Detailed Answer:
Hello
Thanks for your query.
Any kind of post menopausal bleeding needs to be investigated thoroughly and should not be ignored.
Please fix up an appointment with your gynecologist at the earliest.
The most common cause of post menopausal bleeding is hormonal imbalance, wherein the lining of the uterus thickens ( called endometrial hyperplasia ).
This is more common in overweight women and in those who have diabetics.
Generally, for such a patient, I would first examine the lady internally ( per speculum and per vaginum examination ), and order a pelvic transvaginal ultrasound.
If the lining of the uterus is thickened ( cut off level after menopause is 4 mm ), then the next logical step is to have a biopsy of the uterine lining.
THis is a simple minor office procedure.
This is essential to rule out the possibilities of uterine cancers, which might occur in this age group, though the incidence is quite low, so do not worry, only the investigation should be done.
Also, there is a chance of having a cervical or endometrial polyp or a growth on the cervix which could be causing such bleeding.
Adenomyosis ( thickening of the wall of the uterus ) and fibroids are rare post menopause but still need to be ruled out.
A combination of a thorough gynecological evaluation and pelvic ultrasound ( biopsy if indicated by ultrasound scan ) will reveal the diagnosis.
Please do not ignore this symptom of post menopausal bleeding, and have a consultation at the earliest.
All the best.
I would be happy to address any follow up questions if you should have them.
take care.

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