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Spotting after starting combined continuous hrt

I am post menopausal and started taking combined continuous hrt in October for osteoporosis as I can’t take any of the meds for it.  I spotted for one day at the end of November.  Nothing since.  I am 67 and post menopausal since 52.  I saw my gynecologist and she wants me to get an ultrasound.  I really don’t want to as 8 months ago I had one and it was read wrong and said I had a thickened endometrium.  So I then had a hysteroscopy and biopsy which was benign and doctor said my endometrium lining was atrophied.  This is stressing very much.  Any suggestions.  Doctor did raise the progesterone to 200 mg daily from 100 mg and kept the estradiol patch it .025.
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Chances are that the HRT triggered the bleeding and it's nothing serious. But all post-menopausal bleeding should be investigated to be sure all is ok. Interestingly, an atrophied lining can cause bleeding due to instability yet the risk of cancer is extremely low when the lining is thin. Of course, a thickened lining can cause bleeding and so can fibroids and polyps (which can sometimes make the lining appear thicker than it is as it can be hard to differentiate them from the lining itself). I hope this helps.
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