Menopause little spotting twice in 4 months

Patient: Hi I am 51 years old and stopped my period 3 years ago in November I spotted very little after lifting a heavy object just once now 4 months later it happened again very little spot of blood no cramps p ain I also been under a tremendous amount of stress when I inserted a tampon no blood was on it so I thought maybe hemorrhoids caused it not sure

Symptoms: Spotting after menopause

Doctor: Hi,Thanks for the query.I understand your concern.Postmenopausal bleeding should be carefully evaluated.The possible causes of bleeding in your case are atrophied endometrium of menopause leading to exposure of underlying blood vessels which can increase their fragility and cause bleeding, atrophied vaginal mucosa which is more prone for infection, rare causes like cervical or endometrial neoplasia, coagulation abnormalities etc.As you mentioned sometimes bleeding due to hemorrhoids can be mistaken for postmenopausal bleeding.By direct examination and investigations, only the possible cause of your problem can be identified and treated.So, better to consult your doctor, get examined and go for investigations like ultrasound, pap smear, coagulation profile etc.According to the findings further management can be planned.Hope this helps.Take care.