"Brown spotting" is a result of what is known to the medical world as vaginal atrophy. The atrophy (disintegration of cells and tissue) causes inflammation---dryness and thinning of the tissue lining in the vaginal wall. This makes the area more sensitive to itching and burning sensations, as well as discharges that range in colour and consistency from thick and white to watery and red or brown.
Brown spotting is actually bleeding, but it is considered "old blood" that may not have drained completely during a previous period and is just now being discharged, or expelled, from the body. The brown in actually a darker and more muddy-coloured red that you would normally see with bleeding.
Brown spotting is post-menstrual bleeding, which may be accompanied by severe cramping. It is a normal and natural process of the end of menses, but women may have more cause for concern when they are post-menopausal and more than 6 to 12 months have gone by when the brown spotting occurs. It is not "normal" to have brown spotting years after menopause, so seek medical advice and assistance immediately if this occurs.
Oestrogen is used to treat vaginal atrophy. It may be given in the form of an oral tablet, a topical cream or a skin patch. Lubricants may also relieve some of the internal dryness, whether you are sexually active or not.
Possible Causes of Brown Spotting
Oestrogen reduction, HRT (hormone replacement therapy), birth control pills, non-cancerous fibroids or polyps, genital herpes, as well as vaginal wart viruses, and uterine or ovarian cancers can be at the root of breakthrough bleeding or brown spotting. Bleeding disorders, like leukaemia and clotting issues can also cause abnormal vaginal bleeding. Pregnancy, during its early stages (which causes a cessation of menstruation), can also cause discharges. Medical history has shown that a few women have become pregnant after their monthly periods ended. If accompanied by fever, abdominal pain, unusual mucus or other discharges, it may be sign of an infection. In any case, it is best to seek medical attention to be on the safe side or get a proper diagnosis.
Menopause in HIV-positive Women
According to the NLM Gateway, HIV-positive women experience the same or similar symptoms during menopause as do women who are not HIV-positive. However, HIV-positive women may experience more irregularities with their periods.