Menopause does not reappear for two years. If vaginal bleeding occurs again after menopause and is considered to be abnormal postmenopausal bleeding, it is important to consider whether there are any endometrial lesions. After menopause, the endometrium appears to be atrophied and the endometrium gradually shrinks in a linear pattern. If the endometrium thickens after menopause and menstrual flow occurs, consider whether you are taking health care drugs, such as estrogen-based drugs that can cause the endometrium to thicken and menstruation to start again. In addition, the reoccurrence of vaginal bleeding after menopause cannot be ruled out as a result of inflammation, such as bleeding due to age-related vaginitis. If the ultrasound indicates thickening of the endometrium or occupancy of the uterine cavity, further examination is needed to determine whether there is abnormal endometrial hyperplasia or endometrial cancer.