A 56-year-old woman on continuous combined oral HRT (oestradiol + norethisterone) attends the GP with unexpected vaginal bleeding 8 months after start...

Question

A 56-year-old woman on continuous combined oral HRT (oestradiol + norethisterone) attends the GP with unexpected vaginal bleeding 8 months after starting HRT. She had been amenorrhoeic for 2 years prior to starting HRT. Which is the single most appropriate management?

Accepted Answer

Investigate with pelvic ultrasound and consider endometrial biopsy

Answer

Reassure that breakthrough bleeding is normal in the first 3 months and will settle

Answer

Increase the progestogen dose

Answer

Stop HRT permanently

Answer

Switch to sequential HRT

uk-drcog MCQ (SBA): Unscheduled Bleeding on HRT

A 56-year-old woman on continuous combined oral HRT (oestradiol + norethisterone) attends the GP with unexpected vaginal bleeding 8 months after starting HRT. She had been amenorrhoeic for 2 years prior to starting HRT. Which is the single most appropriate management?