Once you've had a full year with no periods, ANY new bleeding warrants an evaluation. There may be many benign reasons for uterine bleeding - such as overly thinned lining of the uterus from lack of estrogen (atrophy) or from uterine fibroids. It is also common for the bleeding to be coming from somewhere other than the uterus, such as cervical polyps, hemorrhoids or urethral caruncles. It is essential to first rule out any dangerous sources for the bleeding, such as uterine cancer or precancer (hyperplasia), before assuming that the bleeding is benign.
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