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Taking Estradiol hemihydrate transdermal patches. Noticed heavy bleeding. On norethisterone. Should I increase the dose?

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i am currently taking Estradiol hemihydrate transdermal patches 50 micrograms twice a week. I have started to bleed quite heavily for the last 5 months the doctor has put me on norethisterone 5mg tabs initially 3 tabs daily and told me to reduce the dose if the bleeding stops to 1 tab a day.The bleeding has not stopped what should I do increase the dose of norethisterone or increase the estradiol dose or just give up on HRT altogether
Posted Thu, 29 Aug 2013 in Women's Health
Answered by Dr. Deepti Goyal 52 minutes later

Thanks for the asking the query on XXXXXXX

Hormone replacement therapy for menopause should be used at the least possible dose and for the short period only.So, increasing the dose may not be a good option.

Bleeding occurs due to estrogen (estradiol) and is controlled with progesterone(norethisterone). So, to control this bleeding either you should increase the dose of progesterone or decrease the dose of estrogen. As estrogen increase may increase your menopausal symptoms, you should change the progesterone. You can either increase the dose of norethisterone or change the type of progesterone. Many other preparations are also available with different type of progesterone which can be used. You can also use levonorgesterol intrauterine system after proper discussion and prescription from your doctor.

I would also like to advise you not to make dose changes by yourself and take a proper prescription from a qualified healthcare professional before doing this.

Good Luck.
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