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Menstruation after being in menopause for three years. Should I be concerned?

I haven't had a period in three years and assumed I was in menopause. Today, however, I'm spotting and having cramps. Should I be concerned?
It is difficult to answer this question without knowing your age and other things about your personal history, including your weight, your age when you had your first period, your history of hormone exposure, and whether you have ever taken certain medications such as estrogens or tamoxifen. However, if you were in menopause and have now started bleeding, that is definitely an indication to see a gynecologist and have them do a pelvic exam and most likely get an endometrial biopsy. While it is possible that you are simply having an ovulatory cycle or are having bleeding from another cause such as a fibroid, uterine bleeding in a post-menopausal woman is always concerning for endometrial cancer and that needs to be ruled out before further work-up or treatment can be pursued. This is not something to get scared about, since even if this were endometrial cancer most endometrial cancer is caught very early and can be easily managed with surgery; however, because that is a possibility it is definitely very important to see a doctor and get a diagnosis. Other causes of post-menopausal bleeding include fibroids as mentioned above, endometrial polyps, vaginal atrophy, endometrial hyperplasia, certain infections, and even blood disorders.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under Zocdoc’s Terms of Service.

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