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Can Bioidentical Hormone Therapy Cause Bleeding?

Are you wondering if hormone therapy can cause bleeding?

Maybe you recently started hormone therapy and you're on conventional hormone therapy through a typical chain pharmacy, or maybe you’re on bioidentical hormones, or maybe you’re on pellet therapy.  

The question for all these is, can they " hormone therapy" lead to bleeding? The answer is yes.

We treat a lot of patients with hormone therapy but the goal typically (some doctors do promote this) is not to cause bleeding.  So if this is occurring we want to look at why and then take a step back.  You may need a dose adjustment or things like this.  In this post we're going to discuss those things as well as some things to be thinking about, in conjunction with your doctor.  You don't want to ignore this and you do want to bring it to their attention. The prescribing doctor of the hormone should know this so that you're not missing things. in this video we're going to discuss all that ok

 

Hormone Therapy and Bleeding

So we want to discuss whether or not hormone therapy, both bioidentical hormone therapy or conventional hormone therapy, can lead to bleeding.  Typically we are referring to the type of bleeding that would be unexpected.  So you are postmenopausal or you have not been having cycles for many months to a year.  Then all of a sudden, you start having cycles.  Usually these are women in their late 40s or early 50s.  Sometimes if you're starting hormone therapy later and you are in your 60s, this could happen to you as well.  This bleeding typically occurs as a result of too much hormones going into your prescription. Now you may be getting and injection, topical, oral, or pellet therapy.  The common denominator for all is elevated hormone levels circulating in your blood.  Just because the formula is high does not mean you will get bleeding.  It is how much is in your blood that matters. 

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Why Does Bleeding Occur With Hormone Therapy

When you get a lot of estrogen in your body, your uterine lining will start to thicken.  Eventually the lining will start to shed and kind of mimic a mensural cycle. Now the bleeding from hormone therapy can very quite broadly. It is typically different than regular menses.  It will come on at more random times.  It won't be every month on the clock like a regular mensural cycle would be.  That's because the hormones are consistently going into your system.  So it's probably going to be more regular bleeding and depending on what's going on with the hormone therapy it may not necessarily stop. 

In other cases the bleeding could be just spotting here and there. It really depends on how high your hormone levels are as a result of the treatment that you're getting. Typically this is going to be an estrogen thing. So if you have really high estrogen you are going to see this when the estrogen is not counterbalance with enough progesterone.  

Sometimes you can suppress the bleeding from high estrogen but really you typically wouldn't really want to do that. If you're having that high of estrogen to make your uterus start bleeding again, then it's probably too much.  Bleeding from hormone therapy can be normal if you are just starting.  At the beginning of hormone therapy your body's getting used to it and this can happen but is should be temporary.  

 

Hormone Therapy and Bleeding What to Do

So what you really want to do if this is occurring is take a step back and make sure your doctor knows.  You want to get them in the loop because if it’s not going away you need to dig a little deeper.   If you’re just initially starting hormone therapy sometimes it's just your body getting used to it.  However, if it's not going away and or your hormone levels are really really high, then you want to make adjustments.  You want to  adjust so that your levels are coming back into the normal range for for your age.

The other thing if it's not going away by making adjustments, you need to start looking at what the other possibilities are.  Some other possible causes of uterine bleeding in postmenopausal women could be things like fibroids.  These can get activated by the hormone therapy.  Of course, uterine cancer can do the same thing.  Infections can sometimes mimic this and give some uterine bleeding. Thyroid imbalance in rare cases can do this too but not very common.

In summary, if you’re starting hormone therapy and you have some bleeding, this is not normal.  It can happen, just want to make sure your levels are not too high and that it goes away in an appropriate amount of time.  So hormone therapy can cause bleeding, whether it is conventional hormone therapy or bioidentical hormone therapy both can cause bleeding.

Hopefully this answers the question about hormone therapy being a cause of uterine bleeding.  If you have more questions about this you can post them in the comment section below.  Keep in mind that I did not cover all the possible causes of uterine bleeding but I did give the most basic ones.  If this is happening don't just assume it is the therapy and it'll go away. You definitely want to bring your doctor into the loop.

If you are having these or other hormone imbalance symptoms and would like a customized plan, click on the link below. 

 

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