Hi, According to the description the possible causes of spotting are: - Sometimes atrophied vaginal epithelium can lead to breaches and spotting. The same thing can be seen with atrophied uterine endometrium. - Local causes like cervical erosion, polyp, etc. - Recurrence of renal calculi, urinary tract or pelvic infection. As you have ruled out the possibility of infection the first two causes should be considered. Any type of spotting or bleeding during the postmenopausal period should be evaluated carefully. By clinical examination and investigations like ultrasound the possible problem can be identified and treatment can be taken accordingly. Atrophied vaginal epithelium can be treated with local oestrogen cream. In case of pelvic infection you may need systemic and local antibiotics. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sree Gouri S. R., OBGYN