Hi again
Just to clarify re your question about what causes the bleed and Sarah's reply - it's not just a question of "the bleed" - I think I posted elsewhere that there are lots of reasons for abnormal bleeding - including those mentioned by Sarah2, vaginal atrophy, ulceration of the enodmetrium caused by too much progesterone, and progesterone withdrawal bleeding. There is also oestrogen breakthrough bleeding (too much oestrogen caused by over thickening of the uterus lining), and oestrogen withdrawal bleeding (caused by sudden reduction in oestrogen levels) - where the lining is sufficiently thickened to have something to shed. There are other causes of course, like certain abnormalities so there is no way of knowing which except by testing/investigation.
When you had the scan which showed the lining to be 1 mm, did the consultant look at the surface - ulceration causes by too much progesterone would be visible? Here is some information I found about progesterone breakthrough bleeding:
Progesterone breakthrough bleeding occurs when the progesterone-to-estrogen ratio is high, such as occurs with progesterone-only contraceptive methods. The endometrium becomes atrophic and ulcerated because of a lack of estrogen and is prone to frequent, irregular bleeding.
You did say yours is just a streak/spotting - whch was all mine was really (spotting).
I agree with Sarah2 that many of us need topical oestrogen as well as full HRT - I do, and I am on a higher oestrogen dose than you - I have never experienced true VA in that sense though. I would have thought though, that you would be aware of soreness, irritation etc if your VA was so bad to cause bleeding - but I have no experience of this! Certainly worth asking for topical oestrogen as this can only do you good!
So frustrating not to have consensus amongst consultants, because mine ( who investigated my bleeding with hyesteroscopy) said he was quite happy for me to continue, which has really made me feel positive about it all, especially as I'm 61 in May eek! If only women did not have to spend our time worrying so much about this crucial part of our lives.
You really need a proper consultation with a specialist to advise on whether to reduce the progesterone, or conversely increase the oestrogen - which is the other option - especially if you are still experiencing symptoms).
You could always have an e-mail consultation with Dr Currie - giving her a brief run down of your history and what the investigations showed and mentioning your worry re the GP/consultant, as you have done on here, and then ask the question as to what she would advise - eg re some of the suggestions given here. It costs £25.
Hope this helps!
Hurdity x