What can cause vaginal spotting 10 years after menopause?

Various reasons: Postmenopausal spotting or bleeding can occur for a variety of reasons. It could be as simple as a vaginal infection (yeast or bacterial), a bladder infection, or an std. It could also be as severe as a vaginal, cervical, or uterine cancer. Either way, post menopausal bleeding is never normal and you should see your physician for a definitive diagnosis.

Must rule out cancer: Postmenopausal bleeding should always be evaluated and taken seriously. Most of the times it turns out to be nothing serious but sometimes it can be a sign of uterine cancer. The next step is to be seen by an obgyn for an ultrasound and an endometrial biopsy.