Gynaecological

Pathways

Overview of managing patients with unscheduled bleeding on hormone replacement therapy (HRT) 

To help support primary care clinicians we have produced a quick reference summary of current British Menopause Society clinical guidelines for unscheduled bleeding on HRT
👉 NCA Guideline Summary.

Endometrial cancer is the fourth most common cancer in women. Abnormal uterine bleeding is the most common presenting symptom.

Unscheduled uterine bleeding is also a common symptom experienced by those who have recently started to use HRT or have recently changed their HRT. It can affect up to 38% of people using sequential HRT and 41% using continuous combined HRT.

The new BMS guidance supports clinicians to identify those who need urgent investigation and treatment from those who can be reassured or have investigations in primary care.

To support health professionals in their decision-making the British Menopause Society issued clinical guidelines in 2024. The full guidelines can be found here 👉  Management of Unscheduled Bleeding on HRT.

Updates to the Gynae Urgent Suspected Cancer Referral Form have been made referencing the BMS guidelines.

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