- With Mayo Clinic gynecologist and obstetrician
Mary Gallenberg, M.D.
read biographyclose windowBiography of
Mary Gallenberg, M.D.
Mary Gallenberg, M.D.
Dr. Mary Gallenberg is board certified by the American Board of Obstetrics and Gynecology and by the American Board of Internal Medicine in internal medicine and medical oncology. She is credentialed as a menopause practitioner by the North American Menopause Society.
An Antigo, Wis., native, Dr. Gallenberg is a consultant in the Department of Obstetrics & Gynecology at Mayo Clinic, Rochester, Minn., and an assistant professor at the Mayo Clinic College of Medicine.
Dr. Gallenberg has been with Mayo Clinic since 1990. She was on the Mayo Clinic Women's HealthSource editorial board and has been honored for excellence in teaching. She also won a Mayo Clinic Excellence Through Teamwork award.
Symptoms (1)
- Bleeding after menopause: Is it normal?
Treatments and drugs (3)
- Bioidentical hormones: Are they safer?
- Hormone replacement therapy: Can it cause vaginal bleeding?
- Testosterone therapy in women: Does it boost sex drive?
Alternative medicine (1)
- Flaxseed: Can it relieve hot flashes?
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Question
Hormone replacement therapy: Can it cause vaginal bleeding?
I'm taking hormone therapy for menopause symptoms. Recently, I've been experiencing heavy vaginal bleeding with clots. This occurs on a regular monthly basis — similar to a menstrual period. Should I be concerned?
Answer
from Mary Gallenberg, M.D.
Some forms of hormone therapy for menopause may cause monthly bleeding. This includes cyclic hormone therapy preparations that contain a combination of estrogen and a progestin. The progestin is used to prevent endometrial cancer if you have an intact uterus.
Hormone therapy can result in bleeding that may be light or may be as heavy as a normal period. If you have concerns about your bleeding and think it might be heavier than normal, you should see your doctor or health care provider.
Potential causes of abnormal bleeding during or after menopause include:
- Shrinking or thinning of tissue lining the vagina and uterus due to a decrease in estrogen
- Uterine polyps or fibroids
- Infections of the uterus, such as endometritis and cervicitis
- Abnormal growth of the lining of the uterus (endometrial hyperplasia)
- Endometrial cancer
In addition to a careful history and physical examination, laboratory tests and diagnostic procedures may be used to identify the cause of abnormal bleeding in menopausal women.
Next questionTestosterone therapy in women: Does it boost sex drive?
- Bulun SE, et al. The physiology and pathology of the female reproductive axis. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/159855291-3/0/1555/100.html?tocnode=54107136&fromURL=100.html#4-u1.0-B978-1-4160-2911-3..50018-2_1399. Accessed Sept. 14, 2009.
- Mohan S, et al. Diagnosis of abnormal uterine bleeding. Best Practice & Research Clinical Obstetrics and Gynecology. 2007;21:891.
- Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, et al. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/159855291-4/0/1524/248.html?tocnode=53759912&fromURL=248.html#4-u1.0-B978-0-323-02951-3..50040-6_1192. Accessed Sept. 14, 2009.
