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[Jules57]

Hi, I have been on continuous combined HRT for two years. Oestrogel 1 pump and 200 mg ustrogen every day. Was feeling anxious and low libido so I increased the oestrogen to 2 pumps in August I think. I had really sore boobs after a few weeks and then suddenly, 2 weeks ago, a small bleed. Boobs immediately stopped hurting, literally the same day. The bleed stopped the same day and nothing in the days after but my GP told me no scan or 2 ww, just stop HRT and wait 6 weeks. If bleeding continues they’ll refer me then. So cold turkey since Tuesday 11th. No symptoms except for spotting which started last weekend, about four days after I stopped HRT. No flow, no pad required but I check every few hours and still there. I’m scared witless. Back in 2022 I had bleeding on my previous continuous kliofem regime and had biopsy and scan. I didn’t realise it was a normal process of screening and the worry made me ill. I thought I had cancer. It was all fine-  lining was 3mm and after a few months I got up the nerve to go back on continuous HRT as I wasn’t sleeping and anxiety was awful. Patches first and then with the shortages, gel pump.  I can’t bear to wait weeks up to Christmas frightening myself silly. I’ve read so much online I could probably sit an exam but nowhere does it say how long spotting like this can last? Has anyone any experience? Thank you x

[bombsh3ll]

Honestly I wouldn't worry about this spotting at all.

You have been on and off HRT and had negative investigations after the spotting started.

Nothing you have said is remotely suggestive of endometrial cancer. It is far more likely to be an atrophic and unstable lining breaking down, or due to vaginal atrophy.

The uterus is designed to bleed and all the angst and scaremongering about "postmenopausal bleeding" is disproportionate, irresponsible and harmful.

I bet you don't even have any risk factors for endometrial cancer such as obesity, diabetes, family history, chronic anovulation premenopausally, unopposed estrogen etc.

You also have previous progestin use as a protective factor (on kliofem) and that isn't even taking account of any previous progestin used within birth control.

Less than one percent of women NOT on HRT who are investigated for PMB have malignant changes. Most probably never comes to medical attention so the actual proportion with cancer will be even lower.

For current or previous users of combined HRT this is even lower still.

I am on a combined pill continuously, have been for 17 years and about once every year or few years I get a bit of painless light breakthrough bleeding.

It doesn't faze me one bit because I understand the physiology and know that I am at exceptionally low risk for cervical or endometrial cancer.

I also pay for a private ultrasound yearly for ovarian screening due to my family history, so I know my endometrium makes Kate Moss look like Kirstie alley.

If you want reassurance without the trauma and mismanagement of going through the NHS you can do the same any time, I use ultrasound direct.

[Jules57]

Goodness I had no idea!!! Everything I’ve read is so terrifying…
No risk factors and I’m normal weight. I’ve had two children and been on the pill back in the day too. No history of anything in my immediate family - sister has diabetes but no cancer. I luckily swerved that. I’ve always struggled a bit with bleeding on the pill and obviously with HRT, and I clearly have been getting my knickers in a twist. I really appreciate you taking the time to respond darling thanks SO much xxx

[KittyKats]

Please try not to worry. I have had lots of bleeding on HRT. For years in fact with spotting and heavy bleeds. Had a recent hysteroscopy with two polyps removed and all biopsies came back normal. My gynaecologist said some women bleed on HRT and you haven't been off it long. Stopping oestrogen can cause bleeding too. You could also have a small polyp. I had two but only one was visible on ultrasound.

I'm a bit confused why your GP told you to stop HRT. All you need is an ultrasound to check everything. As the other poster says the stats are in your favour.

[Jules57]

Thanks so much. After daily spotting in the first week off HRT, I’ve had two days of no spotting this second week,then the faintest hint today. I keep poking and checking! so far I feel fine in terms of my wellbeing . The dr said to give it 6 weeks once I’d stopped HRT and if was still spotting, they’d refer me. I guess they are trying to avoid adding to the waiting lists before Christmas! I appreciate you responding thank you x