What happened after half a year of menopause?

Patient's question:

I am 48 years old. Six months ago, I had a D&C surgery because of excessive menstrual bleeding and thickened endometrium. A month after the surgery, I had a little bit of menstruation, and since then, it hasn't returned. Now, more than six months have passed, and suddenly yesterday, I had a little bit again, along with lower back pain and a slight pain in the lower abdomen. I would like to ask the doctor if I might have a new condition. Could bleeding after menopause be due to a tumor?

Doctor's answer:

Analysis of the condition: Women in menopause often overlook the presence of gynecological tumors due to irregular menstruation. Moreover, the symptoms of tumors are also irregular vaginal bleeding, making it difficult to distinguish from clinical manifestations.
Advice: It is recommended to check with a gynecologist, have a cervical cytology smear test, and undergo a color Doppler ultrasound of the uterine adnexa. Since there was endometrial thickening during the previous D&C, if the ultrasound still shows endometrial thickening, it is best to have another D&C.
Doctor's inquiry:

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