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25:48
Bleeding on HRT: Understanding and managing this common side effect of hormones | Felice Gersh, MD
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Apr 11, 2025
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“Isn’t it abnormal to bleed after menopause?” I get asked this question all the time. It depends on your hormone therapy. If you’re not on hormones, then yes, postmenopausal bleeding absolutely should be investigated because it could signal uterine cancer. But when we use cyclic hormones to restore physiologic balance, predictable monthly bleeding that mimics your natural period is actually a sign of health. It means your body is responding appropriately to rhythmic hormone support, growing and
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Estradiol pellets can cause uterine bleeding because... Some women develop hyperplasia, an overgrowth of the uterine lining, and the main symptom is often random, heavy bleeding. It’s a big problem because it’s unpredictable and hard to control. Even when progesterone is given, sometimes the levels just don’t help. The lining keeps overgrowing, and bleeding continues. This is especially concerning for women on estradiol pellets, where uncontrolled bleeding has led to unnecessary hysterectomies.
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