The short explanation
Light, irregular bleeding is common in the first few months after starting hormone therapy and often settles by itself. With some types of therapy, a regular monthly bleed is expected. But tell your doctor if bleeding continues beyond the first few months, is heavy, or starts again after it had stopped. Sometimes the cause is a polyp or a thickened womb lining, and less often a cancer of the womb lining, which is why unexpected bleeding on hormone therapy is checked rather than ignored.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- Your doctor will ask which type of therapy you use, how long you have used it and the pattern of bleeding. They may arrange an ultrasound and, if needed, take a sample of the lining.
- Do not stop or change your therapy on your own; talk to your doctor first.
- Keeping a simple diary of when you bled and how much helps the assessment.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This answer cannot tell what is causing your bleeding. That needs an examination and sometimes an ultrasound or biopsy.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- Is this bleeding expected with my type of therapy?
- Do I need an ultrasound?
- Should the type of therapy be changed?
- What kind of bleeding means I should come in straight away?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
Get help the same day
- Get care the same day if bleeding is heavy, or you feel dizzy or weak.
Book an appointment soon
- Tell your doctor within a few days if bleeding continues beyond the first few months or has started again.
Raise it at a routine appointment
- Keep your regular hormone therapy review appointment.
Sources
The evidence this explanation is built on.
- Womb (uterus) cancer NHS
- Uterine cancer MedlinePlus (US National Library of Medicine)
- Menopause NHS
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial (AI-assisted draft) AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off, and no person on the editorial team has read it yet. That is what the “Written with AI assistance” label means. It is queued for an editor to read, and then for a clinician who works in this area. The sources it was drafted against are listed above.
- Review status
- Written with AI assistance — not yet reviewed by a person
- Last reviewed
- Not yet reviewed by a person
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
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