Hi Pat, I'm so sorry to hear about your GP's aversion to HRT for ladies at an older age - it's a situation I dread. I assume there are no medical reasons for stopping HRT?
Though I'm younger than you by about a decade, I started Evorel Conti 3 years post-menopause, i.e. nearly 2 years ago and have had either spotting or bleeding intermittently for the entire 2 years. As my meno symptoms are not well-controlled, I have had brief trials of other regimes during this time but have had to return to the Evorel as so far, nothing has suited me better & I cannot manage without HRT. Another change is in the pipeline!
I wonder whether it's possible that the spotting could be due to atrophy if you have had to cut your dose & need the oestrogen - there is no need to answer this - I know it's a very personal matter, I just thought perhaps it might be something to think about. I have sometimes found it impossible to know whether my spotting is vaginal or uterine (the bleeds proper are obviously uterine but these have been related to regime changes or occurred during the initial 3 months acclimatisation to HRT, so are more or less explainable).
Because of the bleeding & spotting, I had to be scanned (ultrasound) after a few months then scoped (hysteroscopy) when it continued after the first 6 months, but nothing worrying was found, though I do have atrophy & it's been suggested that the spotting is due to this. I also had a recent normal (though difficult) cervical smear.
If you feel you really need to continue with HRT, I think I would try to find a more sympathetic GP or ask for a referral to a Menopause Clinic, as feeling obliged to muck around with the dose will be a worry for you and is possibly confusing your body. It could just be the changes of dose that have caused the spotting, but I think if you can bear it, I would want to discuss this & future use of HRT with a meno specialist or at least a supportive GP with an interest in the subject, who should be able to help determine the source of the spotting & perhaps carry out one or two minor investigations, just to be on the safe side.
I don't know whether you also use Vagifem or some other local oestrogen product, but if not, this might be advisable for the health of the GU tract, especially if you are having to reduce or stop HRT altogether. If you already use local oestrogen, any reduction in systemic levels (through being obliged to cut your patch) might mean you need a higher dose locally.
A clued-up practice nurse might be a good first point of contact if you can ascertain whether your surgery has one, but whatever you do, I feel you need support with this. Please try not to worry, but do push for help - I think it can be hard for medics to grasp how difficult menopause can be if they have not been through it themselves or didn't have an especially hard time of it. If you need to stay on HRT then you may need someone in authority to support this decision if your GP doesn't approve or understand. I wish you luck with it and have fingers crossed that you will get the help you need.
