Regular bleeding on continuous HRT.

[ConstantlyFuriosa]

I’ve been taking continuous HRT - daily oestrogen (2 pumps) and 100mg tablet of progesterone since 2023. In the early days I had some spotting and irregular bleeds and knew that might be the case. Three years on and I have what seems to be a ‘period’ at least once a month; sometimes every fortnight? It’s not heavy but can be heavy enough to use tampons for a couple of days.

the blood is regular colour; not too dark and it’s not massively heavy, but as I say, enough to use tampons.

Is this normal on continuous HRT?

This happened to me. I had 2 hysteroscopies and biopsies which came back negative so had the Mirena coil fitted as I was advised this would help to stop the bleeding. It didn’t and the gynaecologist said several months later that it was mostly likely down to the HRT so I put up with it for a further 3 - 4 years before going back earlier this year and getting checked out again only to find I had endometrial cancer. A total hysterectomy, 25 sessions of radiotherapy and 4 brachytherapy sessions later I am hopefully cancer free. It’s been a scary and emotional time that I wouldn’t wish on anyone so please don’t ignore it or alter your HRT yourself, go and get checked out, I wish I’d gone back sooner. I don’t mean to scare you but any post menopausal bleeding is not normal and should be checked out and if they say it’s ok but it continues, go back and get checked again on a regular basis

@ConstantlyFuriosa You need a scan to rule out endometrial hyperplasia and worst case endometrial cancer.

Women on HRT have a very low risk for this- far lower than women not on HRT.
However, the rule is assume it's cancer until proved otherwise- that is GP guidance and that's what your GP should be doing.

Please don't put it off any longer. It may well be that you just need an adjustment to your HRT.

IF there was anything seriously wrong the sooner it's found the better. Treating hyperplasia or early endo cancer is relatively easy but leaving something that's showing a risk, is not a good idea.

Make an appt with your GP. If you say you need an urgent appt you should get one and a scan within a few weeks. The guidance for GPs is try changing the HRT dose first and/ or a scan within 6 weeks for women on HRT.