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About 8 years ago I started having hot flashes and had a total of 2 periods in 1 year. My doctor, at that time, put me on Premphrase. My hot flashes stopped and I stopped having periods. I have changed doctors, and now I am on 4.5mg/1.5mg Prempro. However, for about the last 1 1/2 to 2 years, I am been spotting. I never know when this will occur nor how long it will last. A lot of times it is just in the mornings. My doctor did do a vaginal ultrasound and I have 3 cysts. He told me at that time it is nothing to worry about. Will the spotting ever stop if I do not have these removed, or is there something else that could cause this? Could caffine and stress cause this?


You could try going to a lower dose of Prempro (0.3/1.5 mg) to see if that would solve the problem.  In my own practice if bleeding and spotting do not stop, I recommend the patient have an endometrial biopsy or a sonohysterogram to look for a polyp.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati