HRT and me: I finally feel good – but why am I bleeding and spotting so much?

One of the best things about menopause (yes, there are more than one) is the end of your periods. But bleeding has been a major part of my menopause journey this year and it’s lead to a worrying couple of months.

It began with a GP appointment. It had been almost six months since I’d been given Evorel Conti as a make-do hormone replacement therapy (HRT) after Covid-19 precautions stopped me getting a coil fitted and I needed a new prescription.

However, I was a bit concerned because I was bleeding. Often. Every couple of weeks I would have a “period”, sometimes as heavy (and almost as painful) as my true ones, and in between I would rarely go more than a couple of days without spotting. I’d had to put away my nice knickers and wear the old faithfuls, the sort your mam would warn you about not having a road accident in.

Obviously I did what everyone in this situation does and turned to Google and read:

Most women do not have a regular monthly period with Evorel Conti. However, bleeding or spotting does often occur in the first few months until treatment settles down.

Closer googling unearthed forums on Mumsnet where other women were also having bleeding, so I took a deep breath and accepted it.

But then Mr 50Sense said: “Again?” when I told him about a new round and I realised I was bleeding or spotting more days than not. And six months did seem more than “the first few months”.

Fast-track to Worryville

When I told the doctor – a locum, covering during the pandemic – he said he would recommend I changed over to the coil and inform Dr B, who does the fitting.

However, Dr B was not so happy and before I knew it, she was talking about getting me fast-tracked for ultrasounds and seeing gynaecologists and checking for cancer.

I’d been brushing my teeth when she called and I sank down onto the edge of bath in disbelief. No one on Mumsnet had mentioned cancer.

Dr B was wonderful, calmly discussing her concerns and why she thought this was the best action. We needed to get anything serious ruled out, she said. But then she called back straight away and said: “I’ve been thinking and perhaps you should stop taking your HRT,” and my heart did a little flutter. (We compromised on a half as I was scared of going cold turkey.)

Sitting there, I came to a decision: cancer has struck several members of my family and my in-laws, so I wouldn’t tell them about this until there was something to tell, either good or bad. I didn’t even want to tell Mr 50Sense, but then he was off ill when I had to go for the scan and I had to explain why I was suddenly drinking gallons of water!

Ah, yes. The great How Much Water to Drink for an Ultrasound debate! The clinic told me to drink two litres, but a quick chat on Twitter found this was a much-disputed number. Some women had been told a pint, others that they’d drank too much and had to wee some of it off… In the end, I compromised on a pint and a half and crossed my legs and fingers.

At the women’s health centre, where motherhood rules

Medical procedures fascinate me and I lay there enthralled as she read off numbers and discussed my “fast asleep” left ovary compared to my “very young-looking” right, where a follicle was “11”.

I raced back home to tell Mr 50Sense. “What does all that mean?” he asked. “Haven’t the foggiest,” I replied, and then promptly took to social media to boast about my “young-looking” right ovary.

As time went on, however, that C word kept coming back to my mind and I googled facts about ovaries and follicles, looking for reassurance that the internet couldn’t provide.

Off to the women’s health centre

A couple of weeks later, I found myself sitting in the nearest women’s health centre to see the gynaecologist. Why they call it a “women’s health centre”, however, I have no idea as there wasn’t one piece of literature or poster or pamphlet for women’s health that didn’t relate to pregnancy and childcare. Images of babies and happy families were spread wall to ceiling. “Motherhood health centre” would be a more appropriate term.

My internal rant waylaid some of my fears.

You see, I’d been blasé when talking about the tests, saying it was nothing to be concerned about, but a niggling part of my brain kept saying: “What if…?” After all, I’d started bleeding yet again that morning…

In fact, I was so nervous that when they told me to undress and wrap a paper blanket around me “like a sarong”, I did a full strip and walked out tightly holding on to as much decency as possible.

“Noooo,” laughed the gynaecologist. “Just your bottom half!”

Well, it broke the ice.

Next, I was stirruped up, discussing the weather in a very British way as bits and pieces were stuck up my vagina and wiggled around.

“Your cervix is a bit…”

“Wonky?” I proffered. “That’s what they told me in Spain during a smear test once. They said it was more difficult because my cervix was wonky.”

Well,” said the gynaecologist. “I wouldn’t be so rude. It’s… playful. Likes to hide.”

See? That’s the difference between the Spanish and the British NHS.

Wonky or not, it turns out I have a cervix that really doesn’t like people poking around in it. Especially people trying to do smears or biopsies. I closed my eyes and concentrated on mindfulness techniques, focussing on my breathing and trying not to imagine John Hurt with a Baby Alien moving around his stomach.

After what felt like an age, the gynaecologist said: “You’ve done really well. I’m waiting for your scans to come through, but I’m getting the biopsy sent off straight away. I think it’s HRT related, but if it is cancer, we can hit it running.”

Fistula fistbumps

I thought I would feel more nervous after the gynae appointment, but her words made me feel much, much better. The matter-of-fact way she explained what she was doing and why brought about an almost Zen-like calmness: if there was something there, I was in the best hands so better to find out.
Straight out of the clinic

Not long later, I coincidentally received a DM on Twitter from someone going through a similar situation. Through our conversation, I explained what was happening to me – she was the only person apart from Mr 50Sense and my Pausitivity colleague Clare that I had told.

And it felt good.

By telling her what I had gone through, I was not only able to prepare her a little more, but also reassure myself. There was a process here and experts behind it.

More importantly, though, I was able to lift a little of the load I’d been mentally carrying by keeping it secret. By shining a light on it, I could put things into perspective and look at the facts, which were that it was more likely to be the HRT than anything else.

I still had a huge sigh of relief when my letter came through agreeing with me and saying everything looked good. It also gave me lots of medical details to geek out on and I know fine well my new party piece will be telling people the size of my uterus.

I also heard from my DM Pal, telling me she had fistulas.

“Fistula fistbump,” I proudly replied!

Wonder if she knows the size of hers…

Looking to the future

So now it looks as if I may finally get to my holy grail of HRT – a Mirena coil and oestrogen gel – 20 months after I was recommended it by the now-head of the British Menopause Society.

The ironic thing is, emotionally, I’m actually feeling really well on the Evorel Conti! I’m taking it with Sertraline, which seems to be counter-acting the effects of progesterone on me, and except for one bad episode of menopause depression, I’ve been more emotionally stable than for a long time. I’ve still had a few bleeds, however.

Any advice?

Finally, if you are experiencing bleeding after menopause, please go see your GP straight away. In fact, let’s make that an order – GO AND SEE YOUR GP.

And share your medical facts with me afterwards.

What are your experiences of Evorel Conti? Has it made you bleed? Please let me know in the comments below and tell me what happened to you.

53 thoughts on “HRT and me: I finally feel good – but why am I bleeding and spotting so much?”

  1. Gosh I just stumbled across your post while googling why am i bleeding on ‘everol conti’. Your whole scenerio could have been written by myself! I too have had an ultrasound and an internal , plus an internal ultrasound, didint know that was a thing! After calling my doctor to tell her I was bleeding, 3 weeks after starting on the patches. After my ultrasound I too got a call from my doctor to come off my HRT ‘immediately’ – eek! Waiting on a gynae appointment, bleeding again this morning and quite sore. Little clots coming away too. Called doctor and now apparently a letter has been sent by the gyne dept at the hospital with ‘advice’ – not seeing them?? Still waiting on my doc calling me. I know I have a cyst on one of my ovaries. But i hadnt had a period for 2 years now bleeding more than I did when I had my periods. Boo!

    1. Some of my GP phone calls seemed to have got lost, so if you haven’t heard from your GP soon, give them a call iand inquire. For what it’s worth, I was told I could remain on the Conti but with regular scans to check my womb lining wasn’t getting too thick. I didn’t want to put that cost on the NHS so I came off it. Let me know how you get on xxx

    2. I am EXACTLY the same!!! Just waiting on the DRs call today after a scan on Friday.. I think I’m going to go au naturel with the menopause now… I can’t be doing with periods again sod it! Best wishes to you xxx

    3. Me too within weeks of staring the patches bleeding and 9 months on still bleeding also had scan last month all ok, bleeding more now than I had done for years with my periods, but I do feel so much better in myself, sleep better, way less flushes and brain fog no more. Just the bleeding and weight gain but is that the patches or is it the dreaded middle age spread.

  2. Same here – 18 months of bliss on oestrogen patch and utrogestan and then bam! Ten weeks of spotting, biopsy, scan, the waiting was horrific. The first option (reduce oestrogen dose) brought all the symptoms back but stopped the bleed. I’ve upped the patch now and feel ok but I expect I’ll bleed in a week or so. Seems like have to have one or the other and bleeding is the least bad.

    One thing two docs have suggested – increase the utrogestan dose to stop the bleeding (although no one has told me for how long or how often, or after how long a time does it become a concern again). This isn’t a one size fits all and it’s so difficult to find someone accesible who knows their stuff. Grrrr

    1. Hi Cat. It is frustrating, isn’t it. You think you’ve found the answer and then bloody Mother Nature screws it up again. All we can do is keep going back to the GP. The more we let them know they’re advice isn’t good enough, the more they’ll have to learn! Good luck x

  3. Hey ladies ,
    Reading a few diff things online ,have been on the conti for a month and have just started bleeding for 2nd time ,heavy and painful like I used to have .normal body getting used to it or consult my doctor??

  4. Mrs vicky saka

    Hello all,Started evrol conti may10th 2021,2weeks later aching boobs and belly ache then a period like bleed 7 days later no bleeding for 4 days then spotting and now today my second appointment with Dr about patches im bleeding again like a period ,Dr gave me another 3 months of patches and of bleeding hasn’t stopped by then it needs looking onto so I suppose that means a lot of prodding and poking down there ohhhhh isn’t being a woman fucking fabulous 😀

    1. It is a bloody trial at times – figuratively and literally!!!!! Evorel conti can cause intermittent bleeding for the first few months. Keep tracking it and if it doesn’t settle, go back and see your GP. Good luck and keep in touch x

  5. Hi.I’ve been on evorel conti for 8 weeks now and have been bleeding for 10 days now. Should I contact my gp or is it just breakthrough bleeding? Thanks Mandy.

  6. I’m 55, been taking EC for last 6 weeks and on that time I’ve had 2 heavy and cramping bleeds with only 9 days between each one, currently bleeding for the second time. I am still waiting to hear back from my GP (will be phoning them again tomorrow). I haven’t had a period for over 10 years and it’s horrible. In between I feel like I’ve been born again…. But this bleeding is getting me down, I’m not accepting that the bleeding is ok. Now I’m having to buy sanitary wear and take pain relief for the cramps…. That doesn’t seem right.

    1. Hi Julie. I hear ya. I’m on utrogestan now and the pain from the bleeding this time is just like my period pain of old. What did your GP say? x

    2. It’s rubbish isn’t it?!! I wonder where the bleeding comes from, I’d rather not take hRT if that’s going to happen… I’ve removed my final patch -forget it!
      Sexy pants and clean again -yes please 🙂

      1. Once you’re post-menopausal, you should be able to get HRT that means you don’t bleed – altho’ some poor souls still get some. I’m telling ya, there’s no way I’m still using towels and walking like a duck at 60!!!!! x

    3. Hello I’m in the same boat as such, 8 months of bleeding with only 4 maybe 5 days in between when im not bleeding, no period for 5 years then start evorel conti patches and this im giving up CAN NOT stand the bleeding it heavy to my normal periods when I had them were nothing compared to this its making me down, I feel like im paying to make myself bleed and cost of prescription and sanitary products is rediculous,£ 35 to £40 a month of sanitary products because bleeding is heavy, ive had tests at hospital and all is well its the patches dr says it should calm down after 12 months but not willing to wait that long sorry but im giving in no more hrt for me

      1. Vicky your story sounds identical to mine bleeding on and off now since April, numerous examinations/ scans with gynae given all clear but the bleeding continues . Hard to decide what to do next , dread the thought of No HRT . Pray the bleeding eventually stops but as of yet doesn’t look likely .

  7. Hi
    I have been on EC for just over 2months I am 58 and was feeling horrific before .i am a new woman on these but am so surprised with the bleeding . I haven’t had a period for well over 9 years going back to sanitary products and periods oh gosh . Also my breasts are constantly painful,big and my nipples are so so sensitive. I feel so much better in myself but do I have to endure this for long or will it stop .

    1. Hi Angela. Thanks for stopping by. It may be intermittent bleeding from the start of the HRT (happens to a lot of women), but any post-menopausal bleeding should be investigated, so give your GP a quick ring to ask. Always best to check x

  8. Hi I have been on EC for 3 years with no signs off any spotting or problems from day one , however on a long car journey recently and felt lower back/period pain and realised I’d had a short but heavy bleed…. Been to doctors and had an examination , she says everything feels look fine but to come off EC and if don’t bleed in next 6 weeks can go back on …. But if I get another bleed whilst off it then I’ll get ‘referred’ . I’m scared to come off it ‘cold turkey so might halve the patches for the next few times but I’m confused …. Could it be the EC that caused it … after 3 years with no problems I wonder? Or something more sinister in which case I’m worried about waiting 6 weeks …. Help!

    1. Hi Debs. I wish I could help. For the majority of women, post-menopausal bleeding is usually for a non-cancerous reason, such as polyps or a thinning vagina wall, but it’s something we always have to get checked out in case. You shouldn’t be left worrying, however. I would ask to see another GP and explain your fears to them. You’re entitled to have full reassurance. Go make the call today and let me know how you do xxx

  9. Stumbled upon your site. Thank you for posting. I’m 53, on Evorel Sequi as GP says I’m not allowed on Conti until age 55 (altho NICE guidelines say 54). Bleeding a lot – at least 2 weeks out of every months. Had an ultrasound, have some fibroids. I’m going to stick with it, as I do feel better, libido has returned and I’m firm believer in the benefits of HRT (new research out about reduced Alzheimers risk wooo!) but wondering if this is it forever with the bleeding. Was wondering about paying for a consultation with the Newson clinic as they seem so very knowledgeable, far more that the average GP (no offence to GPs btw!) and wondered if anyone else had tried this service.

    Thank you!

    1. Hi Juju. Louise is one of the top people and only has top people working with her, so you would be in good hands. You could also ask your GP to refer you to a menopause specialist. (I was told 55 for Conti too!) The bleeding may also settle down after a few months. Mine did after about 6 months, which isn’t what the manufacturers say (but then, they’re trying to flog HRT so they would, wouldn’t they!!!!) x

      1. Hi, I also suffer from lots of bleeding and I’m on my fifth month of patches. I was interested in your post because you said it took six months for your bleeding to settle. Is this still the case and have you continued with the patches?
        Thank you in advance for any advice 😊

        1. Hi Samantha. When they did tests, they discovered I’m still perimenopausal, so the patches I was on weren’t right for me and I had to change – which was a shame, because the symptoms had actually settled down and I was feeling good! If you continue bleeding, please see your GP and just double-check everything. x

    2. Hi, Juju . It was helpful reading your post because it was exactly me !! I’m on my fifth month of Evori patches and although I feel so much better I’m bleeding for 3 weeks every month 🥲I’ve had scans and I have fibroids w( which are slowly getting smaller ) but so much bleeding is really getting me down. My doctor has told me to preserve and I would like to try so I was wondering how you are getting on now a couple of weeks on from this post .
      Thank you

  10. Andrea Beardshall

    Hi I have been on EC for just over 2 months – now bleeding for the first time whilst using it. Related? Waiting for GP phone call to discuss.

  11. After ~4 months I had quite a major bleed. At first I thought noting of it and then Google pointed to calling my GP who promptly had me on for a check up and then booked me for a scan within 2 weeks. She advised me to stop the patches and I tore them off right away as I found the whole thing quite scary. The ultrasound didn’t show enough so I had to have the internal version which didn’t show anything too serious but they want to keep an eye on what looked like a little haemorrhaging so I’m back in 3 months. That day I decided to go with the patches again as I’d gone back to no sleep, anxiety, mood swings etc. Within a week the bleed happened again and GP advised me to stop until after my next scan. I told her that was going to be tough so she advised antidepressants which I refused. I’ve asked her to refer me to a local menopause clinic which she didn’t seem thrilled about but I just don’t think she has the knowledge to treat me. In the meantime, whilst I wait for my appointment I’m on evening primrose and pukka menopause serenity…

    1. Hi Samantha. Well done on asking to go and see a menopause clinic. We need more advice than GPs can give at times and it sounds like this is one of those times. But please, think over anti-depressants as an alternative. They have many benefits that can help menopause symptoms and may be able to help you – I’m on them and I know several other women who supplement their HRT with them. Have a wee investigate and let me know how you get on. Good luck x

  12. I started on half a patch of the everol conti patch which wasn’t quite enough for a few months. It was then upped to a full patch and all the crappy symptoms disappeared, my energy levels were back. Then the bleeding started, carrying on for 8 weeks, doctor suggested I revert back to the half patch which I did. A scan was booked and the probe! The only concern was a thickening of the uterus so a hysterectomy was booked much to my dread. However the half patch resulted in the bleeding stopping, whooppee but no energy. When I went to see the consultant and explained the change in dose and the bleeding he said the thickening was due to hrt so the camera was not necessary. Mental fist bump and cartwheels cos no bloody energy. My own doctor is now thinking about the gel, referring me back to the menopause clinic and said the increase of the risk of cancer due to possible continuous bleeding that could happen if I stayed on the patches. Now I have to wait and feel like an extra in The Walking Dead until I get my HRT.

    1. Hi Jackey. It’s good you’re getting referred to the meno clinic. I’ve been told that half a patch wasn’t a good way to go because it doesn’t guarantee an even distribution of all the hormones, so you’re not sure how much of each you’re getting. (Would love to hear from a doctor about that please.) My experiences have taught me how important lifestyle is along with HRT, although I admit I still have a long way to go on that!!! We’re told HRT is a magic pill (or gel!) that can solve all your woes, but I don’t think it’s that true for many of us. Let me know how you get on x

  13. Hi I was on Evorel conti for approx two months my weight blew up and my breast hurt like hell. The consultant changed me to ugesteron and evorel 50. Which has been fine, although my nipples still hurt but i lost some weight, so that was good. Then boom, two months in and im getting heavy breakthrough bleeding. The consultant was going to introduce some testosterone when i next speak to him in oct to help with my low libido. Im so fed up with it. Ive not had a period since i was 42, im now 56, its making me so down. Especially as ive just met a nice man after being single for 12 years.

  14. So pleased to come across this article.
    I too have been bleeding more often than not. I have been in Evorel Conti for 7 months. I had felt so much better initially but the bleeding is getting worse and I am starting to not feel very well. My breasts hurt most of the time and beginning to worry.
    I will be calling doctors tomorrow

      1. michelle stratford

        Thankfully a doctor referred me for an urgent ultrasound scan within a few days. I’ve also had blood tests and swabs taken.
        Ultrasound showed a fibroid behind my uterus so unlikely cause of bleeding.
        I have now been referred for an urgent biopsy through my cervix.
        Blood tests were ok and swabs ok.
        Still bleeding and been advised to stay on EC until results of further tests.
        A GP who specialises in menopause and HRT us calling me after the Xmas break.
        I have not had a period for 5 years and this now feels like periods again. I get so much pain. I am 59 years young.

  15. I am 53, I hadn’t had a period for 14mths but needed HRT, so my GP put me on EC at the age of 52. I was on it for about 3 mths when the bleeds started, day before our holiday. I use menstrual cups so it didn’t bother me too much. Then 2 weeks after we got home I had another so called my doctor who suggested a six weeks break to see if it was the patches. No bleeds off them so have been back on them for about a month & I’ve had a fairly light one followed a couple of weeks later with a heavier one. I found this thread/post trying to find out how long this tends to last. I feel so much better on the HRT, so much less tired, bitchy & the hot flashes are all but gone do don’t want to have to come off, but the heavier ones are a nuisance. Will mention to my GP at my next review & maybe see if they stop after about 6 mths, if not we’ll see what she suggests then.

  16. Hi I have been on evorel conti for 9 weeks and now started spotting I was on gel and utrogestan before that but on 12th week had spotting so my dr took me off this and got me to try patches I’m really worried if it keeps up and my dr tells me to stop the patches as I have been diagnosed with osteoporosis in June and have a weak left side of jaw which I have had problems with my teeth so really want to have the hrt to help with my osteoporosis wish I was told at 50 when going through menopause about benefits of hrt as only just been trying hrt since this June has anyone else suffered headaches and backache while on patches

  17. Amanda Tattersall

    Glad to have found this page. I’m 65 and have been on Evorel Conti since June last year. My GP didn’t and probably wouldn’t prescribe for me so I bought from an online pharmacy and pay for it myself. I feel 100% better on it; no severe joint pains, sleepless nights, bad skin, feeling horrible, fat, unattractive and sexless. The first 4 months, I had no spotting at all but it’s like I’m having a montly period now, boobs get tender, tummy swells and then I have some bleeding. Initially not much but this time it’s been like a proper period but only for about 3 days and has virtually stopped now. I can’t bear to have to think about coming off it but I guess I need to go and talk to my GP? I have read it can take up to six months or so for the bleeding to settle so just wondering if I should give it a bit longer. Anyone else experienced the same?

    1. Hi Amanda. Please see your GP – HRT is very safe, but it still needs to be on your medical records and you’ll save a fortune getting it on the NHS. Buying online can be very dangerous (I know you’ve probably done your research on the pharmacy) and all medication should be with a doctor’s knowledge. Talk to your GP and tell them how much the patches have helped and that you want them on prescription. Let me know what happens. xxx

      1. Amanda Tattersall

        Thank you. I did a lot of research, having worked in the medical profession, but I know I need to talk to my GP. I’ll pluck up the courage! x

  18. I have just turned 55. No periods for 2 years so was put on sequi by mistake in august for 6 weeks then changed to conti. Breakthrough bleed and stomach cramps every 2 weeks, then nothing for 3 weeks and 4 days haha I count! And bloody painful boobs and bleeding constantly 20 days so far! Gp telephone call yesterday she asked me to come to the surgery so she could examine me and told me to stop the hrt patches and booked me in for an urgent scan and a possible biopsy. Am so fed up of it all. Wanted HRT as I couldn’t cope any longer with hot flushes and I had tried every other product available! So the plan now is to.wait and see the scan results then possibly switch to another HRT! X

  19. I am 52 and had my last period 4 years ago. I suffered awful menopause symptoms and for a long time until I gave in and spoke to a Dr. I started Evorel Conti in October and started bleeding in late November. Apart from a few days break I have bled continuously until now. I spoke with a nurse at my surgery who said this was normal in the first few months but I am starting to worry as bleeding for 2 months does not seem normal and I cannot find out much information on it.

    1. Hi Jill. Can you go back and speak to your GP. A nurse won’t have the knowledge you need (or the ability to refer you to a specialist). Most bleeding is nothing serious (especially when you’re just starting a new HRT regime) but it is always best to get it checked out. You need a second opinion even if it is only to put your mind at rest. x

      1. I will do that, thank you! It is difficult to get to speak to a Dr where I am, due to COVID and a nurse rang me after I filled in an online consultation form. I need to be firmer and have a proper conversation with the Dr that prescribed them to me. I feel sooo much better on the patches but this is a very unwanted side effect. The ironic thing is that the bleeding has almost stopped today and has turned into spotting. I am hoping this means I am turning a corner with it but don’t want to get my hopes up. Thank you for your help.

  20. I’m nearly 63 and have been on Evorel Conti for three months. Feeling good but had a bleed for a fortnight and now for three weeks with no sign of stopping. How long should I persist before asking for a change?

  21. I was switched from everol to everol conti a few weeks ago and after not bleeding at all on the everol,
    I’ve now only had a few days without heavy bleeding. I’m phoning the doctor tomorrow as it’s just terrible,
    I found your post by googling this problem, like so many it seems!

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