I Am 48 Years Old And Haven't Had A Period

I am 48 years old and haven't had a period in over a year. I am on Estradiol hormone cream, because my hormones are low. I noticed I have some blood coming from my vaginal area. Can this cream cause that? I haven't ever noticed any bleeding before. I haven't had any sex with my husband in months, because I just had back surgery. I am trying to figure out what this could be. I am on other medications as well, due to my back surgery and pain.