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Dr Owen
Dr Owen, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 55754
Experience:  Board certified Ob/Gyn
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I have been taking HRT for 3 years now (Femiston) and have

Resolved Question:

I have been taking HRT for 3 years now (Femiston) and have only ever experienced very occasional spotting during this time. During the last month I have experienced more bleeding and during the last three days the bleeding has become heavier with dark red clots in the blood (the size of a 50 pence piece and some slightly larger) this was accompanied by a feeling of nausea and fatigue. At one point I felt rather unwell and was told that the colour had completely drained from me, causing my partner concern.

What might be the underlying cause of this. Please be honest I do understand that this could be serious or it may not be. Please provide as much information as possible
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr Owen replied 2 years ago.

Dr Owen :

Hello

Dr Owen :

Thank you for your question tonight

Dr Owen :

Well the major reason for this would be the dosage of the HRT that you are taking -

Dr Owen :

and spotting could be due to a dosage that is too low, and you might need a higher dosage.

Dr Owen :

Now, other reasons for the spotting could be due to a thyroid condition, a polyp or a possible precancer/ cancer (although very Unlikely to be a cancer - but this should be checked to be sure).

Dr Owen :

As for the point of not feeling well and your color - this could be due to hormone levels in your body , but this could be due to a low blood pressure or again a thyroid condition.

Dr Owen :

so VERY Unlikely this is serious but Here is what I would suggest at this point.

Dr Owen :

1. I would suggest getting a TSH thyroid blood test

Dr Owen :

2. I would also get an ultrasound to check your uterus and ovaries

Dr Owen :

3. I would also check an Endometrial biopsy too - to make sure this is not serious - as this would check to make sure you do not have a cancer of the uterus - this is a simple test done in the office.

Dr Owen :

Also, sometimes switching away from hormones might be helpful and there is a medication such as Clonidine (was originally for blood pressure issues - but we as ob/gyn's use this medication all the time to help with menopausal symptoms).

Dr Owen :

Also a medication that increases your serotonin and norepinephrine levels will help too - such as Pristiq.

Dr Owen :

I hope this helps

Dr Owen :

Please if you have more questions, please ask

Dr Owen :

Please click on Excellent for helping you

Dr Owen :

thank you

Customer:

Can you explain why the bright red bleeding contains dark blood clots and why after all this time, this has occurred?

Dr Owen :

well the bright red is just from bleeding - and clots are NORMAL to occur as that tells me your body can CLOT - that is very important.

Dr Owen :

and why this is occurring - from above this could be that your body might need a higher dose of HRT (or even getting too much HRT) or you might have a polyp, you might have a thyroid condition, you might have a cancer (Unlikely) = and see what I have written for you - I thought I had explained all of this above

Customer:

Also...the bleeding became worse after excersise (short jog) and also following intercourse

Dr Owen :

okay

Dr Owen :

this could be from irritation or from a polyp

Customer:

Yes you did explain (above) but you specifically referred to the spotting in your answer and I wanted to understand the significance of the clots

Dr Owen :

oka

Dr Owen :

okay

Dr Owen :

just wanted to make sure you understood

Dr Owen :

If you have more questions, please ask

Dr Owen :

thank you

Dr Owen :

Hello

Dr Owen :

are you there?

Customer:

Yes. Thank you I am just reflecting upon what yo have said

Dr Owen :

okay

Dr Owen :

Well get some sleep

Dr Owen :

you will be just fine...

Dr Owen :

and just make an appointment to get the tests done I have suggested

Customer:

Thank you

Dr Owen :

you are welcoe

Dr Owen :

Please click on Excellent

Dr Owen :

That would be appreciated for helping you

Dr Owen :

That is how justanswer credits me

Dr Owen :

Thank you

Dr Owen :

Hello

Dr Owen :

Can you see the Excellent button

Dr Owen :

that is the only way we get credit for helping you

Dr Owen :

did you not want to give me credit for helping you ?

Dr Owen :

Well I wish you well

Dr Owen :

Please click on Excellent before you leave - that would be greatly appreciated

Dr Owen :

thank you

Dr Owen, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 55754
Experience: Board certified Ob/Gyn
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