Britain’s top menopause specialists have released a warning for women who bleed while on high doses of hormone replacement therapy.
It comes after a surge in cases of patients on the drugs being sent for cancer tests.
Guidance from the British Menopause Society (BMS) reassures women that bleeding is a common side effect within three to six months of starting or changing HRT.
But the document states that unexpected bleeding could be a warning sign that HRT dosing is not quite right and advises women to speak to a GP or specialist about adjusting the amount or type of medication.
Surging use of HRT – and risky high dose prescribing – is thought to be behind the increase in women reporting unexpected bleeding over the past few years.
Guidance from the British Menopause Society (BMS) reassures women that bleeding is a common side effect within three to six months of starting or changing HRT. (Stock image)
The guidelines clarify that any bleeding should be reported to a GP as it could require a change to the dose of HRT. (Stock image)
Rather than immediately seek referral to a gynaecologist, women are instead advised to monitor their unexpected bleeding. (Stock image)
Surging use of HRT is thought to be behind the increase in women reporting unexpected bleeding over the past few years. (Stock photo)
The new guidance is the latest effort from British menopause experts to reassure women and alleviate pressure on the health service. (Stock image)
While normally benign, irregular bleeding after menopause can also be a sign of endometrial cancer, which impacts more than 9,700 women in the UK each year.
As a result of the ‘trend’ for high dose prescribing by some private doctors, experts have warned that scores of women have been referred for cancer checks – in most cases unnecessarily.
Aside from the worry this causes, the tests are invasive and take time. The past three years have seen a 43 per cent increase in patients being tested for womb cancer – despite no rise in the number of cancers being diagnosed.
The new guidance is the latest effort from British menopause experts to reassure women and alleviate pressure on the health service, following the launch of clinical guidelines for healthcare professionals earlier this year.
Rather than immediately seek referral to a gynaecologist, women are instead advised to monitor their unexpected bleeding – and are reassured that the symptom ‘is unlikely to represent any serious problem’.
The guidelines clarify that any bleeding should be reported to a GP, however, as it could require a change to the dose of HRT.
Menopause specialist and BMS adviser Dr Kristyn Manley said: ‘Unexpected bleeding is worrying and there are long waiting lists for these tests and procedures, which increases the stress even further.
‘While all irregular bleeding is distressing, there is a need to prioritise investigations for those with a potential increased risk of endometrial cancer, over those in whom endometrial cancer is unlikely.’
HRT patient Karolyn Andrews said she had unexplained bleeding due to taking her dose incorrectly.
‘It wasn’t until I read about HRT and bleeding that I realised that not taking my HRT correctly could have contributed,’ she explained.
‘With these guidelines my GP would have been better equipped to manage this without the need for investigation. I would have avoided the anxiety, discomfort and time off work associated with referral treatment.’
