Thank you for your consult at DoctorSpring.com.
A vaginal ultrasound that is clear pretty much rules out ovarian cancer.
Yes, vaginal atrophy does explain the spotting, post coital spotting, the discharge and the pain during intercourse.
Local estrogen gels and creams should mitigate the problem.
There is no need to insist on a CA 125 test in absence of any ovarian mass.
All the best & Please feel free to discuss further.