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[Diamonds and pearls 53]

Hello, I am a newbie although I have lurked for ages,learning a lot and grateful to feel that I am not alone in battling the menopause. I wondered if anyone here has experienced post meno bleeding on continuous low dose hrt? I have been on  Conti hrt (Indivina) for 4 years and it has been excellent for me but then in Jan this year i had a couple of weeks of very light post coital bleeding.Both Smear test and swabs taken proved to be fine but doc took me off hrt and referred me for a Trans vaginal scan to check my womb lining.This was also ok so was told i could go back on hrt,much to my relief! Anyhow fast forward to July and again I had 2/3 wks of very light bleeding-not sex related this time though.Again swabs taken which were ok and another T.V scan arranged-I didn't come off  hrt this time, just reduced it.The gynae consultant was more than happy with the scan and had a good look at my cervix too which he said was fine,As all bleeding had stopped he said it was ok to keep on with the hrt. 2 months on and its happened again and I have now had a light pinky discharge for almost 4 weeks-I stopped my hrt a week ago but it has made no difference. I have an appt to see my doctor but am feeling fed up-anyone else experienced this or have any idea what could be going on ?

[Hurdity]

Hi diamonds and pearls 53

 

It sounds like you are being properly investigated - but have you been given a reason for the bleeding?

I had the same as you - the v light post-coital bleeding and after all the investigations ( including a hysteroscopy and biopsy - as I had a thickened lining) it was decided the cause was an ectropion ( formerly cervical erosion) - so perhpas you have one of these. I am surprised though that the cause has not been identified as i woudl want to know this.

Presumably you do not have a polyp or fibroids - although would these be visible on a trans-vaginal scan? Have you been offered a hysteroscopy?

I carried on with HRT all the while by the way but I am on cyclical not conti HRT so I would have some withdrawal bleeding anyway.

If I were you I would definitely go back to the doc/consultant and ask them to diagnose what the cause is - and you shouldn't have to stop HRT if your lining is thin.

Hurdity x

[Diamonds and pearls 53]

Hi Hurdity,
Thanks for your reply..my GP's original thought was that it was an ectropian as she thought she could see a slight erosion on the cervix but when I went for the Trans vaginal scan the consultant also examined my cervix and said it was unblemished. My womb lining was thin -2.9 mm and he could see an old fibroid ( inactive) so nothing suspicious there.No mention of a polyp..have had 2 scans now and both times all fine.My G.P (s) seem convinced it is the hrt and seem keen to get me off it at any opportunity but i really want to stay on it as long as I can-if possible. Btw the bleeding was only post coital the first time(not in a relationship now,sadly)-the last 2 times just started spontaneously for no good reason . A hysteroscopy has not been mentioned-what does that involve? Are you post meno btw..if so just wondered why you were on sequential hrt..perhaps that would suit me..

[Londongirl]

 Not exactly the same as you but ..

I am post meno.

Started HRT last year Femoston Conti -kept getting bleeds so I tried various other HRT but didn't feel as good on them so have now gone back on Femoston Conti and am into month 4 and still getting bleeds! 

[Diamonds and pearls 53]

Hi Londongirl,
How long past meno are you...and what are your doctors thoughts on your bleeds?

[Hurdity]

Hi again diamonds and pearls - just off to bed but saw your post. yes I'm about 5 years post-meno, age 60 and choose to be on cyclical HRT because I don't want to take prog all the time. I feel a cycle is more natural even if it does mean using tampons still!!!

I would still want to be checked out re your bleeding though first.

Hysteroscopy they put a long thin camera thing up your vagina and look at your womb more closely. It only took a few minutes. maybe a polyp would have shown up on a scan so as your appeared normal they didn't advise a hysteroscopy?

Hurdity x

[andius]

 
Polyps don't always show up on a transvaginal scan, although with a lining that thin it is unlikely polyps are in there unless they are microscopic. Don't ask me how I know!

However, is it possible you have a touch of VA and the bleeding is coming from your urethra or your vaginal vault?  They might not see the origin with the speculum in place? You could try putting a tampon in and see if the pink is on the top or on the sides of it when you take it out.  TOP= likely uterus, SIDES = vagina. You could also buy urine test strips at pharmacy ( if available there) and check urine for blood.

I agree with others...it needs to be further investigated.

[Diamonds and pearls 53]

Hurdity,
Thankyou for your reply..we are the same age and I am also about 5 years post meno..snap!I did not know you could still take cyclical hrt at this stage-I would not mind still having a withdrawal bleed if it meant I could continue with hrt! I went to see my GP yesterday and she has referred me  for a hysteroscopy and a biopsy.Did you have yours done using local anaesthetic-I would much prefer that if possible (my GP didn't know.)She is still convinced it is the hrt  causing the bleeds and has asked me to stay off it until we find out what's going on..9 days in I am already feeling all the usual horrid effects that come from going cold turkey with my hrt..sigh!
I will let you know how I get on after my appt.. and thanks again x   

[Diamonds and pearls 53]

Andius,
Thankyou for your very informative reply.I have used a tampon to check the origin of the blood and it was definitely stained more on the side-one side actually.Also the consultant did say there was a little touch of atrophy but apparently normal for my age. I have never suffered any discomfort in that area but that was thanks to the hrt keeping everything plumped up I guess. Anyway what you have written certainly gives food for thought!
As I mentioned in my last post to Hurdity ,I now have a referral for a hysteroscopy and a biopsy so I think all the normal guidelines are being followed..but am off my hrt on doctors orders and missing it!
Will keep you posted..and thanks x

[Hurdity]

Hi diamonds and pearls

I didn't have an anaesthetic for mine - I was going to have a local but the gynae said many women had more pain with the anaesthetic than the procedure so I went ahead without. He said he would stop at any time. It did hurt a bit but nothing I couldn't cope with it and it really wasn't very long. If they had found a polyp they were going to remove that at the same time - but they didn't. I was originally booked in for a GA for it - without my knowledge and as soon as I found out I re-booked at a different hospital. Nothing would induce me to have a GA unless I really needed it!

I didn't have as much bleeding as you though - mine was definitely post-coital only.

Good to be properly investigated.

I refused to come off HRT while awaiting my hysteroscopy and right from the start of the injvestigations - in fact they weren't going to refer me until after I;d been off it for 6 weeks and if I then still had bleeding. I got second opinion ( from Dr C on here via £15 e-mail Q) and stayed on it - but as I said my bleeding was minimal. Pinkish like yours but not continuous.

I reported it all on here somewhere - in private lives I think.

Do you have a date yet for the hysteroscopy?

Good luck and yes do keep us posted - interesting you are going through similar and we are the same age! That's where the 53 comes from!! Will let you know more about cylcial HRT if you want more info later. My gynae who did the hyster said he was happy for me to continue on it despite being 60 but tried to offer me a Mriena ( while he was fiddling about up there) which I declined!

Hurdity x

[Diamonds and pearls 53]

Hi Hurdity,
Thanks again,it is great to 'talk' to someone  not only the same age but also who has experienced a similar situation.I too definitely do not want a G.A so will follow your example and shop around if I have to !Very interesting  about the fact that you stayed on your hrt..this will be my 3rd episode of bleeding and the fist time the GP was adamant I must come off,she was positive it was the hrt causing the bleeding/discharge-admittedly it did stop quite quickly. It was a few more weeks until I had my scan and then with the radiographers agreement I went straight back on- I couldn't wait! The next time i saw a different GP and she was more understanding and said I could just reduce it..bleeding again stopped after 2 weeks.This third time,however, the same GP said I must come off it and bleeding has now stopped after 10 days.
I really hope I will be able to continue with it after my 'procedure' but I suppose it depends what they find..it just seems that most GP'S are keen to get you off it asap without looking at the bigger picture. Maybe cyclical hrt would be an option..I will no doubt be back for more advice in due course..I don't have a date for my hysteroscopy yet,hopefully it won't be too long to wait.Thankyou so much for all the info and advice..I will keep you posted. xx

[Diamonds and pearls 53]

Thought I would post an update re my appt at the Gynae clinic at my local hospital to investigate my bleeding issues.
Things did not start well-The nurses were unable to find any records of my last visit in Sept  and only had details of my scan in Feb!
 I gave them details and they decided it was unlikely I would need another scan as my womb lining was thin and the cervix was ok (this was based on  information supplied by me!) I queried this as I said I thought that was what I was there for (Plus I had been led to believe i would be having a hysteroscopy) and on checking  I was told yes, the consultant now wanted me to have the transvaginal scan.I was duly scanned in some detail and  this time the endometrium was very thin-under 1 mm (2.9 mm in Sept) and again evidence of an old fibroid.
 I then saw the consultant ( Different to the one I saw previously) and it was obvious he knew nothing about me. He did not ask any questions and said the bleeding must be coming from the fibroid.I  said i was very surprised as had been told at both previous scans that the fibroid was tiny,calcified and basically redundant! I then mentioned the hrt,and the fact the bleeding had stopped when I came off it and he changed tack and said it was obviously this causing the bleeding and in view of my age (60) -and according to guidelines I must stay off it.  I defended my case but he was not interested ,he said he was going to recommend to my G.P that I should stay off hrt though did concede as I felt strongly that the G.P should refer me to a meno clinic.
So there we are!-I am now 6 weeks off hrt and not feeling too bad but  of course having hot flushes.sleeping badly and feeling very up and down emotionally.I am scared things will get worse!
Anyway off to see my G,P tomorrow so will see what she says.. This is,of course,what I feared would happen...

Diamonds and Pearls

[Hurdity]

Hi again Diamonds and pearls

Thanks for updating us but sorry to hear about the difficulties you've been having regarding treatment, as well as your symptoms off HRT.

It really is unfair the different treatment women get in different areas, having had a similar experience in SW England (ie bleeding, hysteroscopy, scans etc), but where my gynae was happy for me to continue with HRT despite having a small fibroid and what was a thickened lining.

If you don't want to come off HRT then you shouldn't have to, if there are no other problems - but I would certainly suggest going onto patches if you want to continue with it and can get it. Also really at 60 no time to waste ie the longer you are off it the more difficult to start again - and there is some evidence of risks associated with starting later ( although probably less so with patches).

It is strange though that HRT should suddenly cause light bleeding when it hadn't before? Interesting also that your lining was very thin and I have read that atrophy in the uterus lining can also cause bleeding so it could be that in your case the prolonged use of strong progestogen to keep the lining thin has caused excessive thinning? Just a thought?

Good luck with the GP and hope you manage to get referred as soon as possible, if the GP won't prescribe HRT for you, and you want it.

Hurdity x

[Taz2]

What a pain Diamonds and pearls. I too have been advised to come off HRT by 60 so I did that a few months ago - I will be 60 in February - and have had nothing but problems ever since so I understand your wish to re-start it. I just want to say that it was the menopause clinic which advised that I should stop HRT  but the GP will prescribe it as long as it is recorded in my notes that I have been made aware of the risks of continuing past 60 - mainly stroke/blood clots. The menopause clinic referred my menopausal care back to my GP.

Good luck in your quest and let us know how you get on.

Taz x 

[Diamonds and pearls 53]

Hi Taz and Hurdity, thanks for your replies..I do feel quite downhearted as I don't think I  was taken seriously at the Gynae clinic and it was mainly guesswork on the consultants part especially as my notes were missing!-he said that under 1mm for the womb lining was normal but it is it?..plus of course the dismissive attitude towards age-I still feel young and think hrt has helped with that. Hurdity, I will ask my doctor about patches and see what she says -perhaps she will consider this, if so which are the best to go for?
Taz ,how depressing that the meno clinic advised you to stop your hrt..whereabouts in the country are you? As Hurdity says different areas and different doctors seem to vary in their approach! Also ,how soon after stopping hrt did your problems start?-I have the usual withdrawal symptoms but so far am not sore down below-and hrt certainly helped to  keep everything comfortable  there.
Why have you decided to stay off hrt Taz?-I am in two minds whether to try to do the same and see what happens but am worried that things will get worse and then my chance to re-start will be lost!

 Diamonds and Pearls.