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[Beverley727]

I've not had a period for 5 years but started having some light bleeding a few months ago. I've had all of the tests/ biopsy's etc and all clear, except womb lining was 10mm. so referred back to GP. I'm still bleeding, very lightly, one or two days a week. GP says nothing to worry about as all tests fine ... but why am I bleeding?? Any ideas, I'm trying not to worry but it just seems wrong! I'm taking Kliofem tablets.

[Dotty]

Hi how long have you been taking the Kliofem? X

[Beverley727]

9 months now - bleeding started when I'd been on them about 3 months. I was great with evorel conti but haven't been able to get them so had to switch.

[Hurdity]

Hi Beverley - you are most likely bleeding because your womb lining has thickened (termed oestrogen breakthrough bleeding) - this should have been explained to you after your scan. The tests are clear - meaning there are no abnormailites (eg fibroids etc, no hyperplasia, cancer etc) but a thickened lining can lead to endometrial hyperplasia which can lead to cancer if unchecked. The fact that it has thickened is either because you are still peri-menopausal  (even though taking continuous combined HRT) - but this is unlikely if you haven't had a bleed for 5 years, or because the balance of oestrogen to progestogen in this particular HRT type is not right for you - specifically that there is insufficient progestogen to keep your lining thin.

I would suggest the doc is wrong to say nothing to worry about - as s/he should understand the risks of the womb lining continuing to thicken, untreated - of which the bleeding is a good early warning sign!

If you feel otherwise well then a course of extra norethisterone should allow a bleed so enable the lining to be shed, or else a higher dose generally. The other alternative is to take separate oestrogen and progestogen - so an oestrogen tablet (2 mg as you are taking) with norethisterone at a higher dose - but this is not usually prescribed separately as part of HRT though no reason why not. As the HRT you are taking contains 1 mg norethisterone you would need a slightly higher dose to keep your lining thin - if you are otherwise OK with this type. Another alternative is an oestrogen tablet with Provera, a different type of progestogen - which can be taken at lower or higher dose - whicever is needed to keep the lining thin.

Finally another alternative is the Mirena coil which is very effective at preventing the womb lining thickening and limiting bleeds. I am suprrsed the doc did not suggest this to you?

Do have a think about these options and then go back to your doc. You shouldn;t have to put up with abnormal bleeding! If your doc isnot knowledgeable then find another in the practice who is...

Good luck and let us know!

Hurdity x

[Beverley727]

Wow thanks Hurdity, lots to take onboard and I'll be a lot more informed the next time I go to see the GP!