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    Monthly Period after 13 year Menopause
    blondee56 posted:
    5 months ago I began a monthly period after finishing Menopause in my late 40's. I have always been on HRT. I had a biopsy and it is negative however I still have periods and I still have secretion and it smells.

    What do I do now? A second opinion might mean another biopsy and I don't want that. Further getting a second doctor is very difficult as where I live most practices are closed.(Canada)

    What do I do, Doctor says to do my case it is normal. Is that or could that be true?
    Mary Jane Minkin, MD responded:
    Dear Blondee56,
    I'm not exactly clear on what is going on. Are you taking progesterone daily, or are you taking it cyclically? (like taking estrogen every day of the month, and then the progesterone for 10 0r 12 days?)-if you are doing cyclical therapy, the periods may be indeed totally normal. Some women do also develop bleeding while on what we call continuous combined (daily progestin) therapy. A couple of non biopsy options: one would be to do a transvaginal ultrasound of the lining of the uterus, after you finish one of these periods. If the lining of the uterus were very thin, it would be very unlikely that there was anything wrong in the lining of the uterus (and you wouldn't need another biopsy.) the other thought is to look at your dose of estrogen; the lower the dose of estrogen, the less chance of bleeding, in general. Are you on the lowest dose on which you are comfortable?
    So these are options to discuss with your doctor-
    Good luck,
    Mary Jane
    blondee56 replied to Mary Jane Minkin, MD's response:
    Dear Dr. Mary

    You are absolutely right...I am on a cyclical regimen of Hormones and to tell the truth I feel fantastic. I did have an ultrasound, my walls are thin, and the biopsy is normal. I, do, however have an abnormal discharge with a very pungent smell. I am going back to my doctor to see if this is an infection. Otherwise I am glad to read that this could be perfectly normal as I needed that second opinion. I am on the lowest dose of Premarin 0.25mg and there is one dose lower for the Estrogen but I feel much better on a dose of 0.625mg. I have been on these for years but just started breaking out periods exactly on the same day every month for the last 5.
    Mary Jane Minkin, MD replied to blondee56's response:
    Dear Blondee56,
    I don't know if you've been back to your doctor yet for evaluation of the odor. One thing you might try is something over the counter like RepHresh-which will help acidify the vagina to help balance out the normal bacterial flora. If that doesn't work, then you do want to have it looked into by your health care provider.
    Mary Jane

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    For more information, visit the North American Menopause Society website