I keep having irregular bleeding, pelvic bloating, or a family history of cancer — when should I see a specialist? Samar Nahas, MD, MPH, GYN/Oncology at Southwest Healthcare, explains how perimenopause and menopause are defined, what counts as abnormal bleeding (new heaviness, longer duration, or clots), and why postmenopausal bleeding always needs evaluation. She describes office endometrial biopsy technique and pelvic ultrasound, when CA125 or targeted surveillance is used, and which patients should be offered genetic testing for BRCA or Lynch. Dr. Nahas also reviews risk factors (obesity, hormonal treatments, family history) and management options discussed in the conversation, from hormonal therapy and repeat surveillance to prophylactic surgery (removal of ovaries/tubes or hysterectomy) and how those choices affect follow-up care like colonoscopy intervals for Lynch syndrome. The episode gives practical cues on when to seek care, what tests to expect, and how genetics can change prevention and surveillance plans.