Bleeding on MHT

Hi! I'm Dr. Sukhpreet Patel, an Obstetrician & Gynaecologist and founder of MenopauseWize. If you've ever felt uncertain about how to approach a woman with unscheduled bleeding on menopausal hormone therapy, you're certainly not alone. Few areas in menopause medicine generate as much anxiety for clinicians. When is bleeding normal? When should you investigate? Is the progesterone adequate? Does she need an ultrasound, a biopsy, or simply an adjustment to her MHT? Although unscheduled bleeding is one of the commonest reasons women discontinue hormone therapy, most of us received very little formal training on how to assess and manage it systematically. To create this course, I brought together the latest evidence, international guidelines, landmark studies, and practical clinical experience to develop a clear, step-by-step approach that can be applied in everyday practice. In this course, you'll learn: * how to distinguish expected bleeding from bleeding that requires investigation * how to take a focused history and identify important risk factors * when and how to investigate, including interpretation of transvaginal ultrasound * when endometrial biopsy or hysteroscopy is indicated * how to optimise MHT regimens to minimise unscheduled bleeding * practical management strategies for both sequential and continuous combined MHT My goal is simple: to help you approach unscheduled bleeding with confidence, reduce unnecessary investigations, identify women who require prompt assessment, and keep more women safely and successfully using menopausal hormone therapy. I hope this course becomes the practical guide that you can return to whenever a patient presents with bleeding on MHT.