Unscheduled bleeding on HRT

Introduction: We know the benefits of HRT, but Increased prescribing over the last decade (increasing by 13.6% each year)1 has resulted in increasing referrals of women with unscheduled bleeding to gynaecological services (43% over the past 4 years)2.This impacts service capacity and increases anxiety for women awaiting clinical assessment.

Despite rising rates of HRT prescribing and therefore unscheduled bleeding, there hasn’t been a noticeable increase in new endometrial cancer diagnoses (only a 2% rise in the same time period)3. There are five potential outcomes for patients referred to the service from the BMS flowchart: Using the data available, patients were categorised into one of the five potential ‘referral outcomes groups’ that they would have been triaged into, if the BMS flowchart was being used in practice.