Bleeding on BHRT

[BevS57]

I am 55 and went through menopause almost 5 years ago. I use a generic weekly estradiol patch (.1 mg) and Prometrium (200 mg) every night due to extreme menopausal symptoms. I change my patch on Monday evenings. I bleed for several days beginning every other Monday. Could this be caused by the patch losing effectiveness before the week is up? Would switching to Vivelle Dot, which has a twice a week schedule, help prevent the bleeding?

[BevS57]

Thanks for replying. I had a recent pelvic exam and everything seemed fine. Shorty after my initial post, I went back on the Vivelle-Dot and had only mild spotting after three weeks. That week I had forgotten to change my patch for several hours after I should have. So the Vivelle -Dot seems to have alleviated the symptoms. The difference in cost for me is $120 versus $20 for a 3-month mail-order prescription. I am willing to pay $400 a year extra for the lessened symptoms, but others might be financially unable. I have heard that some women change their weekly patch every 5 days with their doctors' approval and the approval of their insurance companies.

[Sanjivani Wanjari, MD]

HI,
It is true that bleeding can occur because of withdrawal of hormones. But this is happening too frequently. Hence before you switch over to another HRT you should consult your gynaecologist to rule out local problems which can cause bleeding like cervical erosion, polyps, fibroids etc.
Hope this helps.