@rainee2025
What type of doctor are you seeing for metformin and ozempic prescriptions? Is it an endocrinologist? If so, have them check your hormones. The combination of menopause hormone changes, lichen sclerosis, obesity, anxiety/stress, etc. could all be contributing to your post menopausal bleeding. Depending on what you are dealing with breast health, that could also be contributing. You may want to focus on overall health and see a nutritionist/dietitian to review diet and supplements to recommend changes and getting more exercise (just start slow with walking). Managing anxiety and stress is important, too, with medications and/or therapy. The therapy can help you focus on self care. While addressing overall health, you can keep an eye on the bleeding to see if it improves with diet changes, exercise, weight loss, stress reduction, reducing anxiety, etc. A hysterectomy is an extreme step and may not be necessary. Most doctors would not approve removal of organs if not warranted and only due to fear of future potential cancer. Genetics and family history may change their thinking on this but insurance companies also require clinically valid reasons for surgery like hysterectomy.

I know it’s not normal, that’s why I’m always so worried and why I went to the gynecologist as soon as I could. But actually, there are a number of reasons it could be happening. The obesity factors in because fat cells turn the androgens to estrogen, which can thicken the endometrium, and may cause bleeding. I was not able to include a link, but if you google post meno bleeding obesity, you can find the same info my doc told me in some detail.
So for me, in the last year I’ve had two hysteroscopy that were both benign. Since the spotting/light bleeding seems to have started again, 2 months after the last hysteroscopy/D&C, I will definitely speak to my doctor again. I agree that the weight thing sounds odd, but it does show up as a common risk factor for causing cancer eventually, which is why she’s saying to lose weight overall.
Regarding hormone bloodwork, yes I had that done back in March from an endocrinologist, which was my first visit. Everything was fine hormone wise, the estradiol was high, but my doctor said they don’t treat based on numbers, they treat when there are symptoms. So, I’m guessing now in my case, this is a symptom!! I’ll be sure to bring that up to her in the next visit.
Only other thing was A1C being in the diabetic range now (6.7, the cut off is 6.4) which is why I started the Metformin. I am due to go back to him in early September, so I suppose I will see what info that brings.
Thank you for responses! This is all just frustrating and I was hoping to see if others had similar experiences, but that haven’t happened yet. I guess we all are different, yet the same!