Hi, Thanks for posting in HCM. I understand your concern. It appears from your description that you could experiencing symptoms like painful intercourse, low back pain and spotting due to lack of vaginal lubrication as a result of vaginal dryness, which generally happens during menopause. There might be vaginal mucosal injury resulting in pain and spotting. In such case, the symptoms should subside by symptomatic management and use of lubricants during intercourse. However, it is ideal to get a pelvic examination done along with ultrasound abdomen, if necessary, to rule out other causes such as uterine polyp or cervicitis. Hope the information provided would be helpful. All the best.