Q: I was four days short of one year from finally being free of periods — only to get another! Does this mean I'm not menopausal, that I have to count a full year without periods again? How would I know I'm menopausal otherwise?
— Diana, Canada
A: A woman is considered to be menopausal when she goes one year without periods. A year is a long time to go without a period and then start bleeding again — it's not a common occurrence. You're close enough to the one-year mark to be considered menopausal, in which case your bleeding may be considered to be postmenopausal bleeding. There are many benign causes for postmenopausal bleeding, such as fibroids, benign polyps, endometriosis, hyperplasia, and a benign overgrowth of the uterus. The bigger concern, however, is that endometrial or uterine cancer may be the cause. So let your doctor know about the bleeding, and find out whether he or she wants to evaluate you for postmenopausal bleeding. The doctor may want to check for the conditions mentioned above and make sure that the lining of your uterus is normal. I doubt that your doctor will be such a stickler about whether or not you're menopausal that he or she won't evaluate you. 
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