Bleeding Problems: HRT and Periods
What effect can Hormone Replacement Therapy have on your periods?
If your periods have not yet stopped when you start HRT, it is important that you have a regime which includes estrogen and progestogen and is given in a sequential manner so that your periods will continue. Sequential HRT is HRT with estrogen taken every day and progestogen taken for at least 10 days per month. This will produce a bleed towards the end of each pack, or at the beginning of the next pack in 85% of users. This type of HRT will not necessarily make your periods lighter, nor will it necessarily improve unpredictable, unscheduled bleeding. Therefore, HRT should not be used primarily as a treatment for heavy or erratic periods.
If you have been taking sequential HRT for several years, or have reached the age of 54 and wish to continue HRT, it can be changed to continuous combined, or period free HRT. This provides both estrogen and progestogen every day and although some bleeding in the first 6 months of therapy is quite common, it doesn't usually cause bleeding thereafter.