Britain’s leading menopause specialists have issued a warning for women who bleed while on high doses of hormone replacement therapy.
This comes after a rise in cases of patients taking the drugs being sent for cancer tests.
British Menopause Society (BMS) guidelines reassure women that bleeding is a common side effect three to six months after starting or changing hormone replacement therapy.
But the paper says unexpected bleeding could be a warning sign that the HRT dose is not correct and advises women to speak to a GP or specialist about adjusting the amount or type of medication.
The rise in the use of hormone replacement therapy (HRT) – and the risky prescription of high doses – is thought to be responsible for the increase in the number of women reporting breakthrough bleeding in recent years.
British Menopause Society (BMS) guidance reassures women that bleeding is a common side effect three to six months after starting or changing hormone replacement therapy. (File image)
The guidelines clarify that any bleeding should be reported to the GP as it may require a change in the dosage of HRT. (File image)
Instead of immediately seeking a referral to a gynecologist, women are advised to monitor unexpected bleeding. (File image)
The increased use of hormone replacement therapy is thought to be the cause of the rise in women reporting unexpected bleeding in recent years. (File photo)
The new guidelines are the latest effort by British menopause experts to reassure women and ease pressure on the health service. (File image)
While irregular bleeding is usually benign after the menopause, it can also be a sign of endometrial cancer, which affects more than 9,700 women in the UK each year.
As a result of the “tendency” to prescribe high doses by some private doctors, experts have warned that dozens of women have been referred for cancer checks, in most cases unnecessarily.
Adding to the concern, the tests are invasive and time-consuming. Over the past three years, the number of patients undergoing screening for cervical cancer has increased by 43%, even though the number of cancers diagnosed has not increased.
The new guidance is the latest effort by British menopause experts to reassure women and ease pressure on the health service, following the launch of clinical guidelines for health professionals earlier this year.
Instead of immediately seeking a referral to a gynecologist, women are advised to monitor their unexpected bleeding and are reassured that the symptom is unlikely to represent a serious problem.
The guidelines clarify that any bleeding should be reported to your GP as it may require a change in HRT dosage.
Dr Kristyn Manley, menopause specialist and BMS advisor, said: ‘Unexpected bleeding is worrying and there are long waiting lists for these tests and procedures, which adds further stress.
‘While any irregular bleeding is distressing, investigations need to be prioritised in those women with a potentially higher risk of endometrial cancer, over those in whom endometrial cancer is unlikely.’
Hormone replacement therapy patient Karolyn Andrews said she had unexplained bleeding because she took her dose incorrectly.
“It wasn’t until I read about hormone replacement therapy and bleeding that I realized not taking it correctly could have contributed,” she explained.
“With these guidelines, my GP would have been better equipped to manage this problem without the need for any investigation. I would have avoided the anxiety, discomfort and time off work associated with a referral treatment.”
