The Biggest Risk of Estrogen Replacement is Uterine Bleeding

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Dr. Maupin and Brett Explain Menopause, Estrogen, and Uterine Bleeding.

Women who have gone through menopause and still have a uterus, experience the loss of estrogen. If they then decide to obtain estrogen replacement, they will begin to have bleeding again. For some women, this is enough of a reason not to seek estrogen replacement. They say that the best thing about menopause is not bleeding every month.

Pellet replacement of estrogen will last four months. This estrogen does not contain progesterone. Without progesterone, they will still be at risk of bleeding. Dr. Maupin’s office will prescribe a nightly pill of progesterone so that the bleeding will be constrained. At that point, those women will have the benefit of estrogen in their system without the risk of bleeding.

You don’t need to have a period just because you are on estrogen. You are getting what you need, but you don’t bleed. If you miss a night of taking the progesterone for some reason, you should not bleed but if you miss two or more nights of progesterone, you will bleed.

Progesterone will prevent the uterus from bleeding, but it will not prevent fibroid tumors or polyps that develop. Those will both cause bleeding. If you are post-menopausal and are receiving hormone replacement of estrogen you should not bleed. If you do bleed, and you are taking progesterone and you begin to bleed, we think in terms of polyps and fibroids. Those reactions can be treated, and we know to look for them because of the bleeding.

Dr. Maupin’s office no longer does the procedures to prevent bleeding post menopausally, but they do have a cooperative relationship with excellent Gynecological offices where you will be referred in order to take care of what procedures you need.  A DNC may solve your problem, but sometimes you need to do more. Once you have a DNC then you increase the progesterone and estrogen, and you don’t bleed. If bleeding continues to be an issue for you it might be that your ObGyn will recommend a Mirena IUD. This will protect you for five years from bleeding.

Our office maintains a list of physicians who understand and accept the treatment provided with replacement of hormones that a woman has lost through the process of aging. If your regular doctor is resistant or avoidant to this treatment and tells you that you should not replace your estrogen or other lost hormones, you should think about getting in touch with one of the physicians on the list who understands our treatment modalities and agree with them medically. The last thing we want our patients to experience is open conflict between their physicians, which will scare them and cause them mental and emotional distress.  We have our research available to you and your doctors, to reassure them that our treatments are safe and preferable.

Don’t be afraid to seek and obtain this treatment for the aging process just because there may be a slight risk of bleeding. Those risks are manageable, or they can be avoided with established medical treatments. Come in and speak with Dr.’s Maupin and Sullivan and or our nurse practitioners, to see about what your unique situation is and how we can provide treatment for it that has minimal side effects and will help you age with good health as the goal.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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