Bleeding on HRT: Understanding and managing this common side effect of hormones | Felice Gersh, MD

Have you experienced unexpected bleeding while on HRT?
So many of you wanted me to talk more about HRT and bleeding. It’s such a nuanced and complicated issue so I wanted to discuss it on its own.

In this talk, I explain why hormone replacement therapy can cause bleeding and why, in most cases, bleeding is simply a sign that estrogen is doing what estrogen does, grow the uterine lining. I explain how bleeding can be either planned or unplanned and how this relates to whether you have chosen to follow the standard low dose static MHT regimen or the cyclic hormone regimen that I usually recommend. And I review the testing your doctor should do to evaluate unplanned bleeding that can't be controlled by simply adjusting your hormone regimen.

Most importantly, I share how you can manage this side effect. Because I think we can all agree that frequent, unpredictable bleeding is not acceptable.

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I am a full time practicing doctor. I see patients in my office in Irvine, CA and worldwide via telemedicine. If you need more healthcare assistance than I can provide in a video series, please contact my office:
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---- Contents of this video --------------------------

00:00 - Why can HRT cause bleeding?
06:19 - If you want no bleeding, this is a challenge.
11:08 - Addressing unplanned bleeding on low dose static HRT
12:27 - Studies that used cyclic HRT or static hormones
14:48 - Cyclic HRT gives you planned bleeding
16:36 - The risk of having unplanned bleeding
19:15 - Bleeding with HRT is usually harmless, but annoying
20:28 - Testing when bleeding doesn't stop