What to do when you think your HRT isn't working.
If you're perimenopausal and start using Hormone Replacement Therapy (HRT), it’s common to experience some unscheduled bleeding during the initial stages of the treatment. This is normal, as it can take time for HRT to regulate your menstrual cycle, and you might notice more than one bleed within a cycle at first. Typically, after about three months, you should experience a more predictable monthly bleed. However, if you continue to have unpredictable bleeding after six months of HRT, we recommend consulting your GP. It's important to rule out any potential issues, such as thickening of the endometrial lining due to oestrogen use or insufficient progesterone coverage for example. If the womb lining becomes overly thickened, it can lead to heavy, unscheduled, or erratic bleeding. If this is left unchecked and undetected this could lead to cellular changes within the womb lining which can progress to malignancy - so don't delay if your still seeing unpredictable bleeds after 6 months of HRT.You might even have an underlying condition, such as endometriosis, ovarian cysts, or uterine polyps, which could have developed while using HRT or been dormant until you started using HRT. If you haven't had a period for over a year and you start using HRT, you should be using it in it's continuous form - so oestrogen and progesterone is used daily - and using it like this will way should not lead to you seeing a return of any bleeding. If however, you do develop bleeding after being bleed-free for over a year, again please do let your GP know. Your safety while using HRT is as important as the symptomatic relief you get from using HRT.