Women’s Health Concern (WHC), the patient arm of the British Menopause Society (BMS), has released a new fact sheet to reassure and advise the growing number of women experiencing unexpected bleeding on Hormone Replacement Therapy (HRT).
With the significant rise in HRT prescriptions in recent years, there has been a corresponding increase in women reporting unexpected bleeding. Consequently, many women at low risk of endometrial (womb) cancer are being subjected to unnecessary and invasive tests and procedures. WHC has released a fact sheet to support these women, following the launch earlier this year of clinical guidelines for healthcare professionals on the management of unscheduled bleeding on HRT.
The new fact sheet reassures and advises women:
- Unexpected bleeding is a common side effect during the ‘settling in’ phase of HRT
- You should consult a healthcare professional if you experience unexpected bleeding.
- There can be a link between unexpected bleeding and HRT dosing.
- How unexpected bleeding might be assessed, monitored and treated.
While there has always been a proportion of women reporting unscheduled bleeding on HRT, the statistics demonstrate the extent of the increase. HRT was prescribed to 1.9 million women in the UK in 2021/2022 – a 35% increase from the preceding year. In parallel, there has been a 43% increase over the past three years in referrals to the Urgent Suspicion of Cancer Pathway (USCP) for unscheduled bleeding. Overall, this change in referral pattern does not appear to have resulted in more cancers being diagnosed.
Dr Kristyn Manley, BMS Medical Advisory Council member and Menopause Specialist, says, “Unexpected bleeding is worrying for women and there are long and growing waiting lists for these tests and procedures, which increases the stress even further. Whilst all irregular bleeding is distressing, there is a need to prioritise investigations for those with a potential increased risk of endometrial cancer, over those in whom endometrial cancer is unlikely.”
The clinical guideline was prepared by the BMS, in partnership with the Royal College of Obstetricians & Gynaecologists, British Gynaecological Cancer Society, British Society for Gynaecological Endoscopy, Royal College of General Practitioners and Faculty of Sexual and Reproductive Healthcare, and service development partners from NHS England and GIRFT (Getting It Right First Time).
Karolyn Andrews, patient, says: “I had not taken my HRT correctly, and as a result, I had unexplained bleeding. It wasn’t until I read about HRT and bleeding that I realised that not taking my HRT correctly could have contributed. With these guidelines my GP would have been better equipped to manage this without the need for investigations. I would have avoided the anxiety, discomfort, and time off work associated with referral treatment.”
Read the new WHC fact sheet:
https://www.womens-health-concern.org/wp-content/uploads/2024/08/33-WHC-FACTSHEET-Management-of-unscheduled-bleeding-on-HRT-AUG2024-D.pdf
Download the BMS joint clinical guideline:
https://thebms.org.uk/publications/bms-joint-guidelines/management-of-unscheduled-bleeding-on-hormone-replacement-therapy-hrt/
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For more information, please contact Kim Gray, Transform Communications:
Email: kim@transformcomms.co.uk
Tel: 01225 863846
About the British Menopause Society
The British Menopause Society (BMS) is the specialist authority for menopause and post reproductive health in the UK. Established in 1989, the BMS educates, informs and guides healthcare professionals, working in both primary and secondary care, on menopause and all aspects of post reproductive health.
About Women’s Health Concern
Women’s Health Concern (WHC), established in 1972 and the patient arm of the BMS since 2012. WHC provides a confidential, independent service to advise, inform and reassure women about their gynaecological, sexual and post reproductive health.
For more information visit: www.thebms.org.uk or www.womens-health-concern.org