Mrs Taylor is a 62 year old female who has come to see you for her annual Asthma review. Mrs Taylor’s Asthma is currently well controlled and you decide to reduce her maintenance therapy. On review of her medication, you note she is on Hormone Replacement Therapy (HRT), which she has been taking for eight years. Mrs Taylor informs you that she started HRT as she suffered with crippling vasomotor symptoms when her periods stopped.
You explore her willingness to stop HRT due to risks of long-term use. She explains that she thinks she needs to continue HRT as she had some spotting and vaginal bleeding last month. Apart from Asthma, Mrs Taylor has no significant medical history. Systems examination including abdominal, bimanual and speculum are unremarkable.
What is the next most suitable course of action?