Sonographic Measurement of Endometrial Thickness as a Predictor of Vaginal Bleeding in Women Using Continuous Combined Hormone Replacement Therapy

1997 ◽  
Vol 44 (3) ◽  
pp. 187-190 ◽  
Author(s):  
C.J. Haines ◽  
T.K.H. Chung ◽  
T.K. Lau
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Vaginal Bleeding ◽  
Endometrial Thickness ◽  
Hormone Replacement

The causes and management of endometrial breakthrough bleeding

2001 ◽  
Vol 9 (2) ◽  
pp. 153-171 ◽  
Author(s):  
M Hickey ◽  
IS Fraser
Keyword(s):  
Hormone Replacement Therapy ◽  
Menstrual Cycle ◽  
Replacement Therapy ◽  
Sex Steroids ◽  
Vaginal Bleeding ◽  
Hormone Replacement ◽  
Vascular Development ◽  
Sex Steroid ◽  
Breakthrough Bleeding ◽  
Normal Menstrual Cycle

The term breakthrough bleeding (BTB) is rather poorly defined, but essentially describes the symptom of vaginal bleeding occurring with scheduled periods of withdrawal bleeding, in the absence of pelvic pathology in women taking exogenous sex steroids, usually contraceptives or hormone-replacement therapy (HRT). It may also describe occasional bleeding in those who are predominantly experiencing amenorrhoea due to these preparations. Rather confusingly, the term is sometimes used to describe intermenstrual bleeding in women who are not taking sex steroids, when structural or other pathological causes are more likely. In the absence of such pathology intermenstrual bleeding in the normal menstrual cycle is relatively uncommon, suggesting that exogenous sex steroids can profoundly disrupt the tight regulation of endometrial vascular development, function and breakdown. Intermenstrual bleeding also occurs spontaneously in some women and it is possible that this phenomenon has similar mechanisms to that seen in sex-steroid-related breakthrough bleeding.

Management of bleeding in women on HRT

2020 ◽  
Vol 31 (12) ◽  
pp. 495-499
Author(s):  
Debby Holloway
Keyword(s):  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Vaginal Bleeding ◽  
Combined Therapy ◽  
Hormone Replacement ◽  
Breakthrough Bleeding ◽  
Practice Nurses ◽  
Post Menopausal ◽  
The Individual

Bleeding while on hormone replacement therapy is common. Debby Holloway explains the causes of this, investigations needed, and how to tailor treatment to the individual if no pathology is found Bleeding while taking hormone replacement therapy (HRT) is a relatively common problem. The majority of women with post-menopausal bleeding – on and off HRT – will have either no cause or a benign cause, but about 10% of women will have endometrial cancer. Post-menopausal bleeding is defined as unscheduled vaginal bleeding that occurs a year after the last natural menstrual period or any breakthrough bleeding on cyclical HRT or breakthrough bleeding after 6 months on continuous combined therapy when there has been established amenorrhoea. Practice nurses must be aware of the problem of bleeding on HRT and each individual needs to be assessed for pathology. If no pathology is found, treatment should be tailored to the individual to overcome the bleeding issues.

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