Our expert says:
Whether you should start a HRT is a decision which should best be discussed with your doctor after comparing benefit to risk.
Although the term “menopause” implies the cessation of menstrual periods, some forms of hormone therapy for menopause may cause monthly bleeding.It varies by the relative doses of the estrogens and progesterone/progestin in the HRT and by whether those ingredients are both taken every day continuously or in a cyclical fashion with the estrogen every day and the progesterone/progestin for two weeks out of four.
Most women will experience some breakthrough bleeding in the first three months on HRT, and this is usually attributed to a hormonal cause.
If women take HRT cyclically, they usually have some withdrawal bleeding each month. Thus a cyclical regimen makes bleeding more predictable but you still have regular “menses”.
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