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[skkb]

Hi Hurdity, wow yes long time....how are things?

I went for the scan in Nottingham on the 17 November. The result was good, all was well and the sonographer was happy. .....”Endometrium thin and uniform measuring 3.1mm. Both ovaries appear normal. Not sure what next bit means “no free fluid, cysts or adnexal masses”.... perhaps you could enlighten me on that bit  Hurdity.
The CA125 came back with a reading of 20, so I left feeling a happy bunny to continue my Sandrena gel 0.5 on a Monday, Wednesday and Friday which is enough to keep symptoms at bay.

SO how scary was it to have a slight bleed over two days Friday and Saturday!!! Nothing major but enough to put the wind up me. Nothing today, so far, but rang 111 yesterday and saw a doctor in the afternoon (which in itself was amazing, quicker than in normal times). He asked all the questions, checked my tummy (all good), urine sample and usual checks but suggested I contact my surgery on Monday as bleeding at 70 should be checked out. So I’ll do that tomorrow. Not what you need a week before Christmas in the middle of a pandemic 😷

[skkb]

This is carrying on from my post in November which for some reason I couldn’t reply to, hence this new thread 🤷‍♀️

[Uptick]

Hi skkb, your scan results are excellent. What is the progestogen of your HRT regime? Why do you use the gel only 3X/week?

[skkb]

Hi, the reason I pay to have the scan is because I don’t have progesterone as didn’t want bleeds anymore, so the scan , hopefully, keeps a check on my “pelvic bits” think I’ve had four scans now. However doctors really don’t like estrogen only unless you’ve had a hysterectomy. Over the years I’ve decreased the dose to three days per week which I’m hoping won’t adversely addict my uterus but keep symptoms at bay. In view of what’s just happened I’m wondering whether stopping the Sandrena to see if the sweats ceased, and when they didn’t I went back on the gel every day for a little over 3 weeks, then back to my present regime...... wonder if that caused the bleed !!

[Uptick]

Probably. So you are on an oestrogen only regime, why's that? Are you intolerant to progesterone? Isn't it risky? Scans can monitor endometrial thickness but not endometrial malignant transformation. 

[skkb]

At 70 I no longer could cope with bleeding, I’ve tried many times over the years to come off the gel completely but feel so awful I go back on.....I hope the scan would show anything abnormal, I don’t know what else to do, a hysterectomy would solve the problem!!

[sheila99]

Can't you use a conti regime? That would give you the progesterone you need to keep your lining thin but you shouldn't bleed.

[skkb]

I haven’t found my doctor very knowledgeable about meno, I’m now thinking of asking to be referred to a gynaecologist who knows more on the subject and maybe have more success. I did my own thing out of frustration with the docs I spoke to, but fully appreciate estrogen alone when still having a uterus isn’t ideal. Originally I never thought I’d still be needing menopause medication after 70......it’s not ideal. The surgery just issue repeat prescriptions and ask no questions 🤷‍♀️

[sheila99]

Ask for a referral to a menopause clinic, gynaecologists are often clueless about menopause. It's a bit scary that they'd give you oestrogen without progesterone. I really think you need to see someone more knowledgeable.

[skkb]

For the last 10 years I’ve felt totally on my own with this, most information comes from online. Think I need a specialised meno doc although reluctant to upset my “system” all over again to try something new as when something feels wrong the worry kicks in

[skkb]

GP surgery just called, they’re referring me to the gynaecology department, should be about two weeks for that to come through 🤷‍♀️

[Hurdity]

Hi skkb

All good here thanks - I can't remember what I said on the other thread but yes I do remember you from quite a while back and I'm chasing you down the decade 

You didn't say what sort of scan it was? Was it TAS ( external abdomen) or TVS ( internal vaginal with probe)? If the latter then the trauma could cause bleeding and may have been from the vagina rather than the uterus. If you are only on a low dose oestrogen and not using vaginal oestrogen then your vaginal tissues may be thin and fragile.

It would be unlikely for a TAS external scan to cause bleeding unless the pressure on your uterus caused this? However if no abnormalities were detected then these cannot be given as cause of bleeding.

Here is some info about adnexal masses:
https://www.healthline.com/health/adnexal-mass

and here is info about free fluid (Scroll down):
https://www.hadassah-med.com/medical-care/departments/obstetrics-and-gynecology-ein-karem/ultrasound/gynecologic-ultrasound/problems-of-the-uterus-and-pelvis

The thing is if no abnormalities are detected then that's great. Also your lining is thin and well below the limits for post-menopause and you're still taking HRT as well. This being the case it shows that your lining is not building up as a result of continuous oestrogen so if you continue to have scans regularly then it looks like you can agree with your doctor to continue in this way quite safely, but keeping a very close eye on things.

You will want to know what could be the cause of your bleeding - but a bleed while on HRT with a lining that thin is very unlikely to be a cause for concern - at least not re endometrial cancer, but of course should be investigated.

Maybe they will want to check your cervix too or has that already been checked?

All the best and good luck with your investigation - do let us know how you get on!

Hurdity x

[skkb]

Thanks Hurdity, so good of you to give lots of info which is most welcome. It was a TVS scan, but that was on the 17 November......so could the bleed come at this late stage? I did stop taking the  HRT for a month in the hope the all would be well but the sweats/flushes  came back so intensely it was unbearable so I took the HRT again but initially every day for three weeks to get my levels back up to where they were, then once the symptoms subsided I went back to my original regime of Monday Wednesday Friday, Sandrena 0.5% (so my does is 1.5% PER WEEK) and this is where I now sit again and symptoms “almost” none which is fine for me. I’m wondering if this tinkering with the dose could have caused the bleed?

However, it has been a wake up call, I’ve always been aware that estrogen without progesterone is not a good idea as I still have a uterus and ovaries. So, I will happily go to the appointment when it comes through to get everything checked out and hopefully talk through alternative regimes with someone more knowledgeable at the hospital. My frustration with my surgery is what prompted me to do my own thing in the first place. Perhaps I became a little to complacent.

My doctor has a copy of my scan report and the CA125 which was 20. Hopefully I’ll hear soon with an appointment but with COVID and everything else that’s going on, who knows.

Have a great Christmas and thank you again, I’ll keep you posted

[Cassie]

I find if I tamper with the gel it def causes a type of breakthrough bleed, so could be that.

[skkb]

Thanks Cassie, hopefully that’s what it’ll be.