Fortnightly review: Management of abnormal bleeding in women receiving hormone replacement therapy

摘要

1. Up to 80% of causes of non-compliance with hormone replacement therapy are related to bleeding 2. Uterine pathology is responsible for up to 30% of cases of abnormal bleeding associated with hormone replacement therapy 3. Perimenopausal women should be advised to take sequential hormone replacement therapy regimens rather than continuous combined therapies to minimise breakthrough bleeding from erratic endogenous ovarian activity 4. Postmenopausal women starting "bleed free" hormone replacement therapy regimens should be counselled about erratic bleeding during the first few months of treatment 5. Abnormal bleeding associated with continuous combined therapy that persists for more than six months and that continues after treatment is withdrawn should be investigated with ultrasound scanning or hysteroscopy, or both.