Management of Postmenopausal Bleeding in Patients on Hormone Therapy

Critical Contraindication Considerations

• For women with a history of cardiovascular disease, such as prior myocardial infarction, stroke, or transient ischemic attack, hormone replacement therapy should be discontinued immediately, as it is contraindicated in these patients, according to the American College of Cardiology 1, 2
• The decision to continue or discontinue hormone replacement therapy during evaluation of postmenopausal bleeding depends on the presence of cardiovascular contraindications, with temporary continuation allowed in stable patients without such contraindications, as suggested by the American Heart Association 3