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Went through menopause, had occasional light spotting. Now starting periods with cramps. Suggest?

Mar 2013
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I am 62 years old and went through menopause at 50 years old. I have had occasional light spotting a few times a year for the last year or two?? Now I seem to be starting up a real period with cramps and everything, though only minimal bleeding. At first brownish, now brightening in color. I have also been very, very tired for years, but I am EXTREMELY overweight and I think some of my medications make me tired, so probably isn't related. This week, however, I feel nauseated and very week.
Posted Tue, 8 Oct 2013 in Women's Health
Answered by Dr. Aarti Abraham 43 minutes later
Brief Answer:

Detailed Answer:
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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