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[terrijane]

Hi

I finished my menopause very early at 43, I'm now 45. I have never had any hormone treatment. About 6 months ago I had some spotting and so saw a gynecologist. An ultrasound and biopsy was done, but no sign of cancer was found.  The gyn said if I had any more spotting to come back and they would consider a hysterectomy. Well I did have some more spotting a few weeks ago so went back. However, this time I saw a nurse practitioner who said that the best way forward would be to have a Mirena Coil fitted as this would keep the womb healthy - she went to check with the gyn and he agreed. She said if I had any subsequent bleeding/spotting after the coil was fitted, they wouldn't be worried about it as this is normal when someone had a coil. I am concerned that ignoring any bleeding after the coil is fitted may be ignoring symptoms of cancer. I asked about the hysterectomy the gyn had mentioned in the previous visit, but she said this would be too drastic.

Is having a Mirena Coil a normal treatment for post menopausal bleeding?
Are there any links to info about how the Mirena Coil helps my situation?
What are my alternatives?
Is a hysterectomy for my symptoms too drastic?

I am scheduled to have the coil fitted next week so would really appreciate any advice anyone can give.

Many thanks
Terri

[Hurdity]

Hi terrijane

 

I am not an expert at all but to me this does sound very odd. No-one has mentioned this on here recently. I don't really understand their reasoning - except the theory is that the Mirena would keep the lining thin therefore preventing it thickening therefore cancer would not develop. However they are normally only recommended in cases of heavy bleeding not spotting and I wouldn't have one for what you have described.

Also the fact that you have had menopause early means you should really have been offered HRT to protect your bones at least  until the natural average age of menopause which is approx 52. Before this age benefits are greater risks and in any case current thinking is that until age 60 benefits are greater than risks ( see this site). http://www.menopausematters.co.uk/balance.php

I am very surprised that the gynae has not suggested this at your young age.

It may well be that as you had early menopause these spotting episdoes could have been a hormonal blip - did you have any other symptoms of pms before they occurred eg tender boobs etc? Have any blood tests been offered ( although these are unreliable in some cases). Have you had any other menopausal symptoms eg flushes or sweats? Maybe you are on other medication which prevents these?

It's good that they investigated the bleeding but what did they give as the reason for the spotting in the absence of anything else? I can't imagine having a hysterectomy for this!! That really is too drastic! Did they check cervix as well as womb lining eg for ectropion? Also vaginal atrophy could cause spotting - but you would have other symptoms of this if so.

Mirena coil can actualy have the opposite effect in the absence of oestrogen, I don't have a reference to hand but the progestin can cause over thinning of the womb lining leading to ulceration and bleeding. Personally I would not have one without also having oestrogen as part of HRT.

If you do consider HRT then we can help advise and there is a lot of inf also on this site - just explore the orange and green menu on the left.

Hope this helps

Hurdity x

[Taz2]

Hi terrijane - just wanted to welcome you to the forum and say that you will find lots of help and support on here.

I am not that clear on the Mirena but wondered when you had your last period? Do you mean that your last one was two years ago when you say that your menopause finished at 43? It is recommended that women who go through early menopause are given HRT up to the normal meno age of 51. Risks from HRT are not applicable in these cases as you would merely be replacing what should have been yours naturally. HRT helps protect your heart and bones during these years.  This is from the menu on the left of the screen

"Menopause - when?

The average age of the natural menopause is 51 years, but can occur much earlier or later. Menopause occurring before the age of 45 is called early menopause and before the age of 40 is premature menopause.

Generally, women having an early or premature menopause are advised to take HRT until approximately the normal menopause age."

I'm sure someone else will be along soon with more info.

Taz x 

[terrijane]

Hi Hurdity,

Very many thanks for your detailed reply. I think the gyn did mention my womb was thinning and this made it a bit difficult when doing the biopsy. I think he said the lining coming away may be cause the spotting. The nurse today said the lining was between 3.5 and 4mm thick and it wasn't really a concern unless lining was greater than 4mm.

The reason I don't think I was offered HRT is because the doctors I saw previously said they didn't think I was definitely on the menopause - then when I saw the gyn about the spotting and told him I hadn't had a period for more than 12 months, he said you're post menopause.

• If I am interested in HRT is it still okay to have it at this stage?
• Should I just talk to my GP about it?
• I am scheduled to have a hysteroscopy on the 27th and they said they would fit the coil then if I wanted it. Do you think I should be worried that if I don't have the coil and keep spotting they wont want me going back as I ignored the treatment they suggested?
• If I did have the coil, would I still be able to have HRT? Would they just give me the estrogen part?
  

Thanks you so much for your help

Terri

[terrijane]

Hi Taz,

It's about 2.5 years since my last period although I did have a one off period earlier this year and since then some spotting. When I have the spotting I do get some stomach pains, but no other symptoms such as breast tenderness that I used to get on a period. I'm definitely going to investigate the HRT; it's something that hasn't been mentioned or I've considered before.

Thanks so much for your reply. I'm so glad I found this forum. I was feeling quite confused and alone after my meeting this morning with the nurse, but getting eeplies on this forum is definitely making me feel better and more informed.

Thank you
Terri

[loobyloo12]

Hi

I know this conversation is quite old now, but I was wondering if there was anybody who could shed a bit of light!

My Mum is in her 70's and had post menopausal bleeding she saw a gynaecologist fairly quickly.  They did a few tests and there was no sign of cancer. But, she had two polyps removed and they said her womb lining is quite thick.  They did a procedure to scrape the womb lining and fitted a mirena coil which releases progesterone to stop the womb lining becoming too thick.  Ever since she has had the mirena coil fitted she has been bleeding. She saw the consultant again and they have given her some progesterone tablets as well. The consultant has scheduled for her to have a hysterectomy.  My biggest concern is she is bleeding very heavily (flooding).  What is causing this to happen and where is the blood coming from because she has very little womb lining after it was scraped away.

Also another thing I should mention, my Mum was never given any HRT when she was going through the menopause.  Would this be the reason why she is having problems now?

Your thoughts would be much appreciated.

Thank you

[Taz2]

Hi loobylou. I'm so sorry that your post appears to have been missed. I'm sure others will be along to advise and support you. I'm afraid I can't give an answer as to why your mum is experiencing continued bleeding but it's good that her tests showed no cancer. Has she got a date for her hysterectomy?

Taz x 

[CLKD]

Any news loobylou?

[Taz2]

It looks as if loobylou hasn't logged on again since her initial posting. 

Taz x

[che]

i wonder how terrijane got on with her coil, my gp wants me to have one due to spotting and i am terrified