Brief Answer:
The source of bleeding should be determined.

Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

I understand your concern.

It is very important to know what is the source of the spotting.

If the bleeding is from the urinary tract or the vaginal area.

If the bleeding is related to burning while urination it is probably due to a urinary tract infection.

The treatment consists in antibiotics to treat the infection.

If the bleeding is from the vaginally area, it can be related to perimenopause symptoms, based on your age.

The lightheadness is probably related to a possible anemia due to the chronic spotting.

I suggest to do a urine test and a complete blood count for further evaluation.

Hope I have answered your query. Let me know if I can assist you further.

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