Hi,

Thank you for your query.

Bleeding after menopause is most commonly caused by endometrial atrophy and this is probably your case since there is just light spotting. Some other possible cases are hyperplasia or endometrial polyp and all these are benign.

Biopsy is recommended if there is doubt about cancer which is rare, but should always be ruled out. It usually manifests with more excessive bleeding, but sometimes there can be just light spotting or no symptoms at all. Risk of cancer is higher in women with early menarche and late menopause, and nulliparous women.

So, biopsy isn't indicated in asymptomatic women, but it should be done if bleeding persists for more than 6 months or if bleeding persists despite hormonal therapy. In all means, I feel it would be appropriate that you undergo biopsy as you are not on medication.

Let me know if you need clarifications.

Wish you good health.

Regards

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