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[Katejo]

When I started Evorel Conti patches last summer, I was told by the meno consultant that I mustn't be worried if I got any bleeding in the first 6 months. I'd now like to hear from anyone who has been using it for over a year. Did the bleeding gradually stop after the first 6 months? Mine is only light (lasting about 24 hours). I have already had an ultrasound scan. The lining is 5 mm which I read was normal for someone taking HRT.

 Another consultant at the same hospital has now said that I have to have a hysteroscopy/biopsy to check the reason for the bleeding. This took me completely by surprise. I had only asked how long counted as 'normal'. I don't want it done if it isn't really necessary because of the associated risks and the pain/discomfort caused. I have already had a smear and a repeat cystoscopy recently and they were clear.

[Machair]

Hello Katejo

 I just wanted to give you my experience, not of bleeding on HRT, but on the lining thickness you mention.

 In the old days when D and C procedures were common, before the days of the Transvaginal scan, irregular bleeding always meant an op to biopsy the lining. Of course this was not as good as it is today with modern camera techniques but it was routinely done. A gynaecologist in the US following extensive research formulated a risk assessment so that women could avoid procedures following a TVS if their thickness was such that pre cancer or even cancer was very unlikely. For post menopausal ladies not on HRT this is 4mm. My lining was 6mm so I had a hysteroscopy. However despite this thickness seen on the scan the uterine walls were in fact very atrophic and too thin to biopsy. It is possible to bleed even from thin tissue as well as thickened.

You could email Dr Currie or ask an expert on Red Hot Mamas as I have done- Mrs Minkin is wonderful and she will answer your questions.

[Katejo]

Hello Katejo

 I just wanted to give you my experience, not of bleeding on HRT, but on the lining thickness you mention.

 In the old days when D and C procedures were common, before the days of the Transvaginal scan, irregular bleeding always meant an op to biopsy the lining. Of course this was not as good as it is today with modern camera techniques but it was routinely done. A gynaecologist in the US following extensive research formulated a risk assessment so that women could avoid procedures following a TVS if their thickness was such that pre cancer or even cancer was very unlikely. For post menopausal ladies not on HRT this is 4mm. My lining was 6mm so I had a hysteroscopy. However despite this thickness seen on the scan the uterine walls were in fact very atrophic and too thin to biopsy. It is possible to bleed even from thin tissue as well as thickened.

You could email Dr Currie or ask an expert on Red Hot Mamas as I have done- Mrs Minkin is wonderful and she will answer your questions.

Hi Machair. Thanks for that. I have had a discussion this week with someone on FB who also had to have a hysteroscopy but was told that it was too thin to biopsy. I had considered sending a question to Dr Currie. I haven't heard of Red Hot Mamas. Is it a forum like this one?

[Machair]

Hi Katejo

It is a website from the US devoted to menopause education and support and there are many expert gynae doctors who will answer questions if you ask them. It is on the home page "Ask an expert section". Mary Jane Minkin is a very experienced gynaecologist who also has her own website called Madame Ovary. I ask her questions as she is absolutely brilliant. The way it works is you ask a question and the website admin team contact her and then you receive a reply usually within a couple of days. It is a free service.

[dht240]

When I started Evorel Conti patches last summer, I was told by the meno consultant that I mustn't be worried if I got any bleeding in the first 6 months. I'd now like to hear from anyone who has been using it for over a year. Did the bleeding gradually stop after the first 6 months? Mine is only light (lasting about 24 hours). I have already had an ultrasound scan. The lining is 5 mm which I read was normal for someone taking HRT.

 Another consultant at the same hospital has now said that I have to have a hysteroscopy/biopsy to check the reason for the bleeding. This took me completely by surprise. I had only asked how long counted as 'normal'. I don't want it done if it isn't really necessary because of the associated risks and the pain/discomfort caused. I have already had a smear and a repeat cystoscopy recently and they were clear.

Hi Katejo,
I've been on Evorel Conti for just over two years. I had bleeding for the first few months and then it settled down. I then had a flooding episode (while in Tesco which was mighty embarrassing). The doctor investigated, I had a scan, a smear etc. but the conclusion was it was a one off (my mum called it a last gasp). All fine for another 14 months and then I had another flood, but much smaller and lasted 24 hrs then stopped. I was so busy I forgot until it happened in the gym 10-days ago. I was dead-lifting and well, you can imagine. I saw my doctor straight away and I've been taken off Evorel Conti, had an internal ultrasound today, and Monday I'm going for further investigation. The doctor believes I'm having a reaction to Evorel Conti, but wants me to take a break while they explore. He has mentioned referring me to the menopause clinic at the hospital.

My best friend from school is also on Evorel Conti, but is on 1.5 patches twice a week and is doing fine. She's been on it for 6 years already and feels amazing on it. No bleeding.

I hope it settles down quickly for you.
D.

[LizzyRad24]

Hi. My name is Lizzy and this is the first-ever forum I've joined, indeed I don't use social media either. I've read this thread as I have some concerns and don't have anyone (bar my fab Dr) to discuss it with. I started using evorel conti patches at the end of September 2019. Since mid-October I've bled lightly everyday, making it now over a 100 day bleed. However nightmarish this is, I still find this better than how I felt prior to the patches. I'm due to have a hysteroscopy on Thursday, but wonder, if anyone could tell me, will the bleeding eventually stop?  At the moment I reckon I've a few more months in me before I might want to throw in the towel! Blood tests have shown my iron levels are fine. Many thanks in advance for anyone who feels they can help me.

[Katejo]

Hi. My name is Lizzy and this is the first-ever forum I've joined, indeed I don't use social media either. I've read this thread as I have some concerns and don't have anyone (bar my fab Dr) to discuss it with. I started using evorel conti patches at the end of September 2019. Since mid-October I've bled lightly everyday, making it now over a 100 day bleed. However nightmarish this is, I still find this better than how I felt prior to the patches. I'm due to have a hysteroscopy on Thursday, but wonder, if anyone could tell me, will the bleeding eventually stop?  At the moment I reckon I've a few more months in me before I might want to throw in the towel! Blood tests have shown my iron levels are fine. Many thanks in advance for anyone who feels they can help me.

Hi Lizzy. Welcome to the forum. I can't answer your question though. My bleeding hasn't been continuous at all. It has only been 1 to 3 days a month since October. Are you having general anaesthetic or local on thursday? Did you have a vaginal scan done first to check for  endometrial lining? Mine was only 5mm.
Please let us know what happens on Thursday.

[Katejo]

Hi Katejo

It is a website from the US devoted to menopause education and support and there are many expert gynae doctors who will answer questions if you ask them. It is on the home page "Ask an expert section". Mary Jane Minkin is a very experienced gynaecologist who also has her own website called Madame Ovary. I ask her questions as she is absolutely brilliant. The way it works is you ask a question and the website admin team contact her and then you receive a reply usually within a couple of days. It is a free service.

  I have now had a letter from the gynae to my GP which includes 1 big inaccuracy so I have decided to write to her and query the need for this procedure. I shall say that I have discussed it with MM members and will quote NHS advice about the risks from their web site. I shall also quote the consultant who advised that some bleeding was normal in the 1st 6 months.
I am much better at arguing points in writing than during an appointment. 
I am also going to the 1st meeting of a new meno group locally tomorrow.  If I get the chance, I will ask for views there.

[shrosphirelass]

Good luck Katejo, let us know how you get on x

[Katejo]

Good luck Katejo, let us know how you get on x

  I went to the new support group. Helpful session. Got to mention my issue about not wanting a hysteroscopy and got support. Will go to the next meeting in February.

[Katejo]

Good luck Katejo, let us know how you get on x

Here is an update on my hysteroscopy/bleeding. I am somewhat frustrated at the moment. The hysteroscopy found no fibroids/polyps/other reasons for concern . However they couldn't take a biopsy because it was too painful for me (cervix very tight). Taking paracetamol/Ibuprofen beforehand didn't help at all. She said that it wouldn't be necessary to have a biopsy. However she rang me back later in the day to say that they did want me to have the biopsy after all under a GA due to the blood visible on their camera. I had had very light  bleeding for about 10 days but it may have stopped today. None so far.

I think that the blood visible is just caused by the Evorel patches and would rather wait a couple more months to see if it stops naturally. I have only been on full patches since last June/early July. If the bleeding is going to continue after that, I will give up on HRT and manage my VA with Vagifem. Not ideal but better than the stress of  repeated hysteroscopies in the future and the nuisance of continued bleeding.

[shrosphirelass]

Sounds really stressful Katejo, I'm sorry. Could you ask them for a further monitoring scan in two months to check the lining / state of play and go from there. When I refused a hysteroscopy, as the cyst they could see was tiny and I was too anxious, they did this for me.  My next scan was clear.

[Katejo]

Sounds really stressful Katejo, I'm sorry. Could you ask them for a further monitoring scan in two months to check the lining / state of play and go from there. When I refused a hysteroscopy, as the cyst they could see was tiny and I was too anxious, they did this for me.  My next scan was clear.

  I did try to ask for this but the doctor was reluctant. I suspect that a more senior doctor had overruled her.  She said I could wait to speak to the meno consultant again but I think that would result in me waiting for longer. 
Really frustrated because I want to book holidays but can't renew travel insurance when I have tests pending despite not feeling ill!  I am expecting  a call back on Monday re. dates and will tell her that the bleeding has stopped.