I started BHRT two weeks ago, and now I am having a period/spotting, even though I haven’t had a period for a year! What should I do?

It’s not uncommon to experience a brief return of menstruation at the start of BHRT, especially if it has been a shorter time since menopause when starting treatment. Generally, the doses of estrogen in BHRT are not high enough to result in a regular menstrual cycle. If you notice bleeding:

• Stay calm. This is usually not a sign of a health issue.
• Spotting or bleeding typically resolves within 1-2 months of continued BHRT use.
• If the bleeding persists, your practitioner may recommend a dose adjustment or further evaluation, such as a pelvic ultrasound.