Will you still bleed on continuous hrt if not post meno?

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Will you still bleed on continuous hrt if you are not fully menopausal? I'm nearly 60 and last year was fully investigated as still having periods and lots of spotting (longest gap between bleeds was 3 months). My blood test suggested I should be menopausal as FSH very high which triggered the investigations but all fine aside from fibroids which I already knew about.

I started sequential HRT in January but switched to continuous after 3 months as I was sick of having periods. I understand that guidelines state continuous is suitable if over 54 regardless of whether fully menopausal. I know you need to give HRT a chance to settle down but after 6 months on continuous (and 9 months total on hrt), I still have a monthly bleed, which seems to last longer every month (currently been bleeding 2 weeks).

I'm at a loss!

Will you still bleed on continuous hrt if you are not fully menopausal?
Yes, sometimes.

It would be very unusual to have regular periods at 60.
When they did the blood tests and scan did anyone look at your ovaries? You might need a more detailed scan with a consultant to see if you have any follicles in your ovaries. FSH tests are very unreliable (mine showed post meno 18 months before I was.)

You're still not into 6 months on continuous however.

Your other option is the Mirena coil or to increase the daily dose of progesterone.

It would be very unusual to have regular periods at 60.

Yes, so I keep getting told and caused my GP to freak out & put me on the cancer pathway (really don't want that again but fear they will want to do it). However, I was most definitely having natural periods prior to starting HRT & I understand it's not THAT unusual.

When they did the blood tests and scan did anyone look at your ovaries?
They did transvaginal ultrasound (as well as hysteroscopy & biopsy) so would assume so.

You're still not into 6 months on continuous however.
Another month and I will be & it's not showing signs of improving.

Your other option is the Mirena coil or to increase the daily dose of progesterone
Didn't get on with mirena when I had it years ago (constant bleeding & acne) but have wondered about upping progesterone as I currently only take 1 tablet to 2 pumps oestrogel.

Who did your scan? A consultant or a sonographer who then sent the results to a gynaecologist.

They ought to be have looked at your ovaries and seen if there was any activity.
There is a huge difference between a consultant doing a scan and telling you at the time what is found and someone less experienced doing the basics.

You have some options- reduce the estrogen dose or increase the progesterone.

BMS guidance is 200mgs Utrogestan daily if 100mgs doesn't control bleeding.

Or you could try dydrogesterone- like micronised progesterone but likely to reduce th e bleed- called Nalvee - now available in the NHS.

thebms.org.uk/2025/09/dydrogesterone-10-mg-now-available-on-the-nhs-hrt-ppc-2/

I do but am 49. I am on continuous to help manage endometriosis. My periods have always been regular and remained that way from switching from sequential to continuous. I’ve been on continuous HRT a year now. I take 2 progesterone tablets a day.

@JinglingSpringbells Not 100% sure but I think doctor rather than a sonographer as she told me that all she could see was fibroids, everything else OK etc. I was referred to consultant as GP worried it was post meno bleeding following the blood test. Consultant agreed scan looked fine but did the hysteroscopy as a precaution. Think they were more worried about endometrial cancer than whether I was post meno. I've been through so many investigations over the years due to my dysfunctional bleeding but they never find anything wrong other than fibroids. Sick of it now.