Brief Answer:
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Detailed Answer:
Hello and welcome,

I wouldn't worry, but I do recommend that you go in to see your gynecologist or primary doctor to follow up on this. After a woman has been without any bleeding for 1 year, then bleeding should be evaluated.

The blood could be from urethral irritation or a mild UTI. So a urinalysis can be helpful, and during a pelvic exam, the doctor can look at the external urogenital tissues for signs of irritation.

Fibroids tend to regress after menopause, without continued estrogen stimulation. But if there are fibroid that are close to the inside of the lining of the uterus, that could be the cause.

Also, cervical polyps can bleed a bit. Most of these are benign but should be checked. A small cervical polyp can grow since your last pap. It can be seen by your doctor if she/he does a speculum exam.

Bleeding can also happen even a few years after menopause if there was a small surge of estrogen from the ovaries which sometimes happens.

These things I've described above are usually not concerning. However, it's recommended to follow up because of the chance of endometrial cancer. There is less of a chance of this than the other things I mentioned. But it is something to rule out. The initial test for this is an endometrial biopsy. It's done with a curette that is at the end of a very thin tube. It's inserted through the cervical opening. Once inside, the doctor will move it to different parts of the inside of the uterus where it will take multiple tiny pieces of the uterine lining which will be sent to a pathologist for evaluation. The procedure is done in the office and does cause some uterine cramping but it's not terrible. I've had it done - not fun but doesn't take long.

So - I recommend you go in to see your gynecologist or family medicine doctor for evaluation. Don't worry, but do go in to get it sorted out.

I hope this information helps. Please let me know if I can provide further information or clarification.

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Brief Answer:
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Detailed Answer:
A family history of uterine cancer does increase the risk, but does not mean you necessarily will get it. Other factors that can increase or lower your risk include having been on oral contraceptives (lowers your risk), pregnancies (lowers your risk), earlier menopause (lowers risk). Obesity, advanced age and a history of pelvic surgery increase the risk.

Keep in mind increased risk doesn't mean it will necessarily happen. Even genetic risks don't necessarily manifest themselves.

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