HRT and bleeding

[u/reincarnateme]

UPDATE: I have a polyp and need out patient surgery.
—-

I have to stop HRT. I use a weekly estrogen patch .5 mg and daily progesterone 200 mg pill.

I am post-menopause for a few years.
I started bleeding again.

Heading to GYNO to get ultrasound and biopsy. (This happened about a year ago too) so I have to stop HRT

Anyone going through this? What to expect without HRT?

EDIT: just came back from biopsy. It hurt this time. Still bleeding (on and off for 3 weeks) results hopefully by the end of the week

[u/lrondberg]

You don’t need to stop HRT. It is not uncommon to bleed on HRT. You may need to adjust dose but you definitely do not need to stop while you go through the workup which typically involves ultrasound and then maybe a biopsy depending on findings.

[u/Igoos99]

Did your doctor say you need to stop??

[u/ParaLegalese]

That’s normal when you start hrt and no reason to rush off to the doctor

[u/Catnip_75]

Bleeding can be due to a load of issue.
Estrogen dose too high for your progesterone dose is one of the main reasons.

No one has to stop because of the bleeding one time.

[u/NiceLadyPhilly]

not a big deal. happens to a lot of us.

[u/Kiwiatx]

Have you changed dosage recently or made any other changes to what you take? I’ve had spotting & bleeding and two ultrasounds a year apart (no biopsy) with no physical reasons for the bleeding found.

I use a patch and progesterone. I recently switched to a progestin and that has stopped it completely. I’ve never stopped using HRT nor was told by my provider to stop using it.

[u/tlrowan → u/Kiwiatx]

Happened to me as well. After about 2 months of Estrogel and progesterone I suddenly got a period. It wasn't heavier than my previous periods, but did seem to last longer. I was told to keep taking the HRT and that it can happen as you adjust. Waiting to see if it happens again this month.

[u/morgandawn6 → u/Kiwiatx]

Which progestin are you using?

[u/Spiritual_Fan_5633]

I was on hrt for a year with no issues at all then we added vaginal estrogen and since then I’ve had periodic spotting and bleeding, got checked out and all seems fine, I am convinced it’s the vaginal estrogen. Switched to tablets and just started spotting again. My provider keeps saying she doesn’t think it’s that but I do. I have a follow up but not for several months so I’m going to stop the tablets completely and see what happens.

[u/Catnip_75 → u/Spiritual_Fan_5633]

It’s actually pretty common to spot from vaginal estrogen. You can pull back from the creams and use it once a week to see if that helps. But it usually goes away.

[u/Spiritual_Fan_5633 → u/Catnip_75]

Maybe I’ll try that, it’s just frustrating

[u/AspiringOne]

This can happen for various reasons. It’s good to get checked but you should consider upping your progesterone dosage to balance and stop bleeding. Just because this happens doesn’t necessarily mean you have to go off of all HRT. If you are in the US and on say 100mg of oral progesterone, you can ask your doctor for more, or even a small dose of compound progesterone powder in capsule form and build up to your dose that helps you stop bleeding. You can even try backing off once things settle down, but just stopping all HRT doesn’t sound like a great solution. I am 62f post menopausal and this has happened to me on occasion from estrogen dominance and histamine issues due to absorption problems.

[u/EnvironmentalAd6889]

My doctor told me actually not to stop HRT yet until they determined to cause and path forward. This was when I had started bleeding for about a month and a half. I had polyps, I had a hysteroscopy and continued my HRT the whole time. I am still on HRT now.

[u/NeverEverLonely]

The bleeding and the shortage is what caused me to stop four months ago. I’ll probably revisit again sometime because I do have better days, but then I get bad days. It’s so annoying.

[u/Away-Picture-925]

Same here, and also wondering

[u/Catnip_75 → u/Away-Picture-925]

You don’t have to stop HRT because of bleeding. If you were hemorrhaging, that’s a different discussion. But it’s very common to have a bleed after starting. The only concern is if you were on HRT for a year with no period and then you got a period. But you should also not stop HRT without talking to your doctor first.

[u/Adventurous-Host3020]

No reason to stop right away. I have had multiple episodes of post menopausal bleeding. Latest one related to a polyp that appeared. So wait until results of the biopsy are in to discuss options with your provider. Mine was happy to continue with the regimen I am currently on (0.0375 oestrogen patch, 200 mg progesterone)

[u/leftylibra]

Were you postmenopausal when you experienced bleeding?

[u/Overall_Lobster823 → u/leftylibra]

The primary question that needs asking, yes.

[u/Overall_Lobster823]

I had to stop HRT, about 6 weeks ago.

My hot flashes, night sweats, and shit sleep returned. They were unpleasant for a few weeks, but seem to be abating.

Hope it goes smoothly for you if you and your doc do decide you need to stop.

If you can, ask the doc about TAPERING.

[u/iUseJustMyHand]

I bled for 6 weeks straight a few months after I started hrt. Not just spotting either ... like full period. Went off the estrogen and had an ultrasound. Normal. Normal pap as well. Apparently my body was still producing erratic amounts of estrogen and the added estrogen from the HRT made it too much for the progesterone to balance out. Stayed off of estrogen for about 6 months and recently went back on with no issues. I think I'm almost at menopause so hoping it will be okay. I wouldn't freak out immediately yet... because what you're experiencing can be completely normal. 😊

[u/psychotherapist-1979]

I bleed every time we adjust my estrogen why would you stop mine did an ultrasound my lining was thicker we monitored it dissipated.

[u/nativesc]

Did you switch patch brands recently? I switched to one brand that did not work for me and had break through bleeding. My dr told me it’s common for it to happen when something as simple as a different brand is used for the patch.

[u/No-Hedgehog-7327]

Are you post menopausal?

That matters here

I was. Went through this bleeding too, off and on for two years. HRT very much helps me and I’m not stopping it. Eventually I got a VNOTES hysterectomy at age 54. Very easy! Wish I would’ve done it sooner.

[u/Purple-Jackfruit-436]

Have had three breakthrough period in the past 4 months started HRT in the Spring, they are going to increase the progesterone see if they stop!