57 – Bleeding on HRT: what’s normal and what’s not
The Dr Louise Newson Podcast
Dr Louise Newson
4.7 • 933 Ratings
🗓️ 14 April 2026
⏱️ 21 minutes
🧾️ Download transcript
Summary
In this episode, Dr Louise Newson is joined by consultant gynaecologist Mr Osama Naji for a reassuring and practical conversation about one of the most common concerns women have when starting HRT, bleeding.
Together, they explain why bleeding can happen, when it is a normal response to changing hormones and when it may need further investigation. They also discuss the common causes of unscheduled bleeding, the role of scans and checks and why women should never be left feeling frightened or dismissed.
Louise and Osama also tackle the fear around endometrial cancer, the importance of looking at the whole clinical picture and why women deserve clear information and individualised care rather than unnecessary alarm.
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Transcript
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| 0:00.0 | Today on my podcast, I've got Mr Azami Najee, he is a gynaecologist in London and also a great friend. |
| 0:06.9 | We talk a lot about bleeding on and off HRT because it's one of the most common side effects of |
| 0:13.4 | taking hormones. It's one that causes a lot of confusion and sometimes concern. So we have a very |
| 0:19.3 | reassuring chat about this topic. So Asama, you're here in real life. |
| 0:26.0 | I've done two podcasts with you before, but remote. So we're in Jack's lovely studio. You're feeling relaxed. |
| 0:33.8 | Very nice place, in fact. Yes. Thank you very much for having me. |
| 0:36.7 | No. Well, you're one of my |
| 0:37.9 | favourite gynaecologists actually and not just mine but lots of women and lots of my colleagues as |
| 0:44.0 | well so you're in the hot seat so I think I can just ask you a few questions because I am not a |
| 0:50.4 | gynaecologist which is fine I don't have anything against gynecologists. |
| 0:54.4 | Very good gynecology knowledge, I have to say, yes. |
| 0:57.2 | But it's interesting, isn't it? |
| 0:58.6 | Because, you know, I specialise in women's hormones. They're made in the ovaries, but they're also made in the adrenal glands, and they're made in the brain. but somehow a lot of gynecologists, not you, I hasten to add, feel that the menopause and hormone |
| 1:13.2 | problems has to belong to gynecologists. |
| 1:15.8 | Whereas in my mind, gynecologists like yourself, specialise in the womb, the ovaries, the reproductive |
| 1:24.4 | organs, if you like, or the gynecological organs. |
| 1:29.5 | Because if there's a disease, |
| 1:31.0 | that's what you treat. |
| 1:35.5 | Whereas you don't want to be treating a hormonal issue where hormones are all around our body. |
| 1:38.2 | So it's a weird concept, really, isn't it? Absolutely. |
| 1:38.7 | Yeah. |
| 1:38.9 | Absolutely. |
... |
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