I’ve developed an irregular bleeding pattern on cyclical HRT. What should I do?

If you are taking a cyclical form of HRT you should expect to bleed on a regular basis, usually at the end or just after you complete the estrogen+progestogen phase of your HRT (you may notice some irregular bleeding in the first 3 months, after which it should settle into a regular pattern).

If your bleeding pattern changes or does not settle into a regular pattern quickly, I would recommend going to see your doctor to discuss it. Prolonged bleeding, heavy bleeding or bleeding that occurs irregularly may require further investigation.

It may all just be due to fluctuations in your own hormones, or possibly a sign to consider trying a continuous form of HRT (if the bleeding seems to stop altogether), but irregular, heavy or prolonged bleeding could be a sign of abnormal changes taking place in the womb lining (endometrium). This needs to be ruled out, usually with an internal examination to check there is no vaginal or cervical cause of the bleeding, and an ultrasound scan to assess the womb.


    • admin

      Many thanks for your question.
      The mini pill can often stop your periods on its own, so with the addition of HRT it is not unusual for bleeding to stop. If you are not having any bleeding at all you could ask your doctor to consider switching you to continuous HRT rather than sequential. However, you should review things again if you start to notice irregular bleeding.
      Hope that helps!

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