If one has a womb 1 requires progesterone in order to keep the lining thin. Regular scans would be offered if a woman has a long regime, i.e. less progesterone with regular oestrogen replacement.
One wouldn't usually be prescribed HRT without a form of progesterone regime if 1 has a womb.
A D&C would be offered if one has heavy, painful periods regardless of any form of HRT.