Post menopause bleeding

[Satori1948]

I am a 58 yr old white female, 3 living children, 5;10" and nearly 300 lbs. I do not and have never smoked or drank alcoholic beverages. Major weight gain following back injury and while bedridden,  & degenerative arthritis. Completed menopause at 56, no period for a year or more. Mother died in June 06 and I had a period, thought it to be stress. Nothing again until my only sister died in Sept 06, bleeding again just as when I was having a *normal* period. In the past few months I have had irregular spotting with cramping, more recently it is a daily occurence, some days just faint show, others perhaps a teaspoon..bright red. Can my overweight, stress be causing this? We moved and have no insurance, husband has been in and out of hospital this year and the bills are mounting. He is self employed so when he doesn't work the bills don't get paid..and I can't find any clinics locally. Can stress and overweight cause the bleeding?
Cancers in my family: my baby sis was a smoker (I am not). She had breast, lung, brain and lymphoid cancer however died of congestive heart failure. Paternal Grandmother died of cancer but not sure what..I think mother said stomach cancer but I was a child and there is no one left to tell me now. Thanks

[Machelle Seibel, MD]

It sounds like it has been a very difficult few years for you.

It is unlikely that stress is causing a period after menopause. But being overweight can. Fat cells are able to produce weak estrogens. If a person weighs 300 pounds, there can be enough weak estrogen to stimulate the uterine lining to bleed again. Over time this can turn to precancer and eventually into uterine cancer.

You really should have an endometrial biopsy. That is an office procedure in which a thin 'straw' is placed into the uterus and a few cells scraped out. The cells can be looked at under the microscope to see if cancer or precancer is present. Depending on the finding, you might need a D & C (a minor operation where the entire lining of the uterus is scraped out (usually in the operating room with some sedation) and/or be treated with hormones to try and change the cells back to normal.

Not having insurance is certainly an issue. Perhaps there is a medical center that you could travel to and they could do this all in one visit. Most hospitals should be able to help you also. The biopsy could be done in most any ob/gyn office.
I wish you the best of luck.
Machelle M. Seibel, MD