A 50-year-old woman starts continuous combined HRT (transdermal oestradiol 50 mcg/day with oral micronised progesterone 100 mg daily). She attends the...

Question

A 50-year-old woman starts continuous combined HRT (transdermal oestradiol 50 mcg/day with oral micronised progesterone 100 mg daily). She attends the GP 3 months later reporting light vaginal spotting. She is otherwise well. Which is the single most appropriate management?

Accepted Answer

Reassure that breakthrough bleeding is common in the first 3-6 months of continuous combined HRT and review if it persists beyond 6 months

Answer

Stop HRT immediately

Answer

Refer urgently for endometrial biopsy

Answer

Switch to sequential HRT

Answer

Increase the progestogen dose

uk-drcog MCQ (SBA): Breakthrough Bleeding on Continuous Combined HRT

A 50-year-old woman starts continuous combined HRT (transdermal oestradiol 50 mcg/day with oral micronised progesterone 100 mg daily). She attends the GP 3 months later reporting light vaginal spotting. She is otherwise well. Which is the single most appropriate management?