What does it mean when your are spotting one week after your period and it is heavy?

Concerning: At 48 years of age that can be concerning for polyp, fibroid, hormone changes, adenomyosis, endometriosis, pre-cancer lesions of the uterus. Basically, you need a doctor to evaluate which of these it might be. Heavy bleeding in women your age definitely needs to be evaluated to make sure there's no concerning lesion causing this bleeding. An simple biopsy can tell you, and ultrasound helps too!