Unscheduled bleeding following HRT - assessment and management

Menopause is defined as permanent cessation of monthly menstrual periods due to permanent depletion of ovarian follicular activity which results in reduced production of ovarian steroids. This in turn causes short term and long term complications in postmenopausal women. Hormone replacement therapy (HRT) is considered as the treatment of choice in the management of these complications. However, unscheduled bleeding following HRT is a well known complication. Diagnosis of unscheduled bleeding is confirmed after careful assessment and exclusion of secondary endometrial pathologies. This can be managed effectively by adjusting or changing the hormone profile in HRT preparations.