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What Causes Spotting Blood Clots After Bioidentical Hormonal Replacement Therapy?
Question: Hi i have been on BHRT since XXXXXXX 2014. My period stopped and I occationally get spotting with lots of blood clots. I have'nt got a period or bleeding since October last year just lots of pelvic and lower back pain mostly on left side. I am on my period now and have been for 2 days lots of clots and bleeding with pain. Is this normal?
Brief Answer:
investigations required
Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Bioidentical hormonal replacement therapy( BHRT) contains hormones estrogen and progesterone. These hormones lead to cyclical periods after menopause, if given in cyclical fashion. If given continuously then there may be no periods at all.
There may be heavy bleeding on hormonal replacement therapy, as the uterine lining grows under the influence of estrogen, and when not shed for a long time, it will cause heavy bleeding with clots.
The pain on the left side of the pelvis can be due to ovarian pathology, or any pathology in the colon or any other pelvic pathology.
Pain in lower back could be due to some spine or paraspinal muscles pathology, for which you should consult an orthopaedic surgeon.
I would suggest you to consult an OBGYN specialist to get properly examined, investigated( ultrasound, MRI if required) and get treated accordingly. Moreover, since you are on hormonal replacement therapy, you should also get a endometrial biopsy done to rule out any endometrial hyperplasia or carcinoma, as risk is increased in women taking this therapy.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
investigations required
Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Bioidentical hormonal replacement therapy( BHRT) contains hormones estrogen and progesterone. These hormones lead to cyclical periods after menopause, if given in cyclical fashion. If given continuously then there may be no periods at all.
There may be heavy bleeding on hormonal replacement therapy, as the uterine lining grows under the influence of estrogen, and when not shed for a long time, it will cause heavy bleeding with clots.
The pain on the left side of the pelvis can be due to ovarian pathology, or any pathology in the colon or any other pelvic pathology.
Pain in lower back could be due to some spine or paraspinal muscles pathology, for which you should consult an orthopaedic surgeon.
I would suggest you to consult an OBGYN specialist to get properly examined, investigated( ultrasound, MRI if required) and get treated accordingly. Moreover, since you are on hormonal replacement therapy, you should also get a endometrial biopsy done to rule out any endometrial hyperplasia or carcinoma, as risk is increased in women taking this therapy.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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