Brief Answer: Atrophied endometrium, abrasions on vaginal mucosa Detailed Answer: Hi, Thanks for the query. The possible causes for your mother's problem are : - During menopause, endometrial layer gets atrophied. That can lead to exposure of underlying blood vessels and can increase their fragility, leading to bleeding. - Usage of vaginal pessary can lead to local abrasions, ulcers etc, leading to bleeding. - Rare causes like cervical or endometrial neoplasia etc. As your gynecologist told that examination findings are normal, there is less possibility for cervical factors and local lesions. So, better to go for ultrasound and coagulation profile. If everything is normal, no need to worry. Usually this bleeding may not repeat. Along with atrophied endometrium, polyps will also get atrophied after menopause usually. She has to change the pessary at regular intervals. If needed she can use local estrogen cream for few days with your doctor's advice. Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion. Take care.

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