A 70-year-old nulligravid woman presents with a three-month history of intermittent, painless vaginal spotting. The patient denies any vaginal bleeding or spotting since her last menstrual period 20 years ago. She initially noticed brown staining on her underwear. Currently, she wears a pad which she changes daily. She reports regular bowel movements with no blood in her stools. She had her second colonoscopy four years ago. No abnormalities were noted. She denies any urinary complaints and has not noticed any hematuria. The patient was last sexually active 15 years ago. She denies any prior history of sexually transmitted infections. Her last Pap smear with co-testing was normal at age 65. She has no history of abnormal Pap smears. She has never taken hormone therapy. Her past medical history is significant for hypertension, hyperlipidemia, and diabetes mellitus. Her past surgical history is significant for laparoscopic cholecystectomy. She is currently taking lisinopril, atorvastatin, and glyburide and she has no known drug allergies.