Perimenopause

* If you're past menopause and haven't had a period for several months -- then start having minor bleeding once a month or so -- you should probably see a doctor.

* "Abnormal bleeding in a woman is always cause for concern".

* When a woman is in perimenopause -- usually during her 40s -- it's normal to skip one period and have one the next month.

* "But if a woman didn't have a menses for nine months and then she bled, [a doctor] would always evaluate that". A pelvic exam, [ultrasound], and possibly a biopsy might be necessary to determine if it is endometrial [uterine] cancer or pre-endometrial cancer, called hyperplasia.

* Sometimes abnormal bleeding does occur. But you really have to watch it; it should be investigated. We're lucky with uterine cancer in that there's always bleeding and therefore we can catch it early [when it is almost always treatable]."

* Perimenopausal bleeding can originate from other problems such as:

Hormone replacement therapy.

Uterine (endometrial) polyps.

Cervical Cancer.

Cuts or lesions on the outside of the vagina sex.

perimenopause