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[laszla]

Hi all, I've just had a pelvic scan to check endometrial thickness because I take less than standard amount of Utrogestan (7-10 days rather than 14), I also take 2 pumps estrogel daily, have a very regular, 3 day bleed like clockwork every months and no spotting.
I had the scan done the day before my period. The scanner told me that the endometrium is 10mm which would be in the normal range at this stage of the month (the secretory phase) if I'm not yet postmenopausal but that it would be definitely thick if I'm postmenopausal. She says she will recommend to GP that I have a blood test to determine whether or not I'm postmenopausal.
My question is how do they determine if one's postmenopausal when you're on HRT? I started this regime 3 years ago and was still having fairly normal periods so how can one determine whether my current regular periods are "real" periods or just bleeds brought on after stopping progesterone phase of cycle?

Many thanks

[Dotty]

Hi you can’t tell if you’re post menopausal if you are taking hrt. The definition of post menopause is 12 months without a period. X

[laszla]

Thanks, I wonder what the scanner meant when she said I'd need a blood test to see if I'm post menopausal, if I am then the measurement is worrying

[Dotty]

Hi my lining was 10mm last year … I had scans and biopsy and all came back clear. I was told that the lining building up can happen with HRT. x

[Menocrazy]

Hi there
I’m new to all this, I was two years into HRT (4 year into menopause) but started bleeding after having a coil removed in April.  Last week my thyroid endocrine dr took blood ref my menopause status for the gynaecologist to look at the next day in my appointment to help sort out the bleeding at first she was “oh that was nice of him, can’t see how much use they will be”. But later in the appointment she had a look and said now I understand why he took them, it’s possible your not menopausal.  I haven’t got the results yet myself so don’t know what they saw but apparently there was a difference to be seen even on HRT. 
Good luck sorting it all out.   

[Hurdity]

Wether you are post-menopausal or not then cyclical HRT acts likea normal cycle so as the scanner said to you - it will build up during the proliferative phase, consolidate and change structurally during the secretory (progesterone) phase, and then when you stop the progesterone it is shed.

The day before your period is the wrong time to have a scan to deterine if you endometrium is thicker than it should be.You shuld ask to time it immediately following your bleed when it is at its thinnest (and don't wait too long afterwards as it will have started building again).

The thickness of the endometrium at its thickest point ( the day before your bleed) if you are post-menopausal is entirely determined by  the oestrogen dose you are taking - and then the progesterone dose/duration - which is why you are sensibly having a scan as you are on less than the recommended amount.

If this was private - then before you have any investigations I suggest you have another scan. Even if on NHS I woud still suggest you ask for another one at a better time ie post bleed.

I have had a couple of private scans and that's when I time them.

Hurdity x

PS you cannot determine menopausal status from blood tests

[laszla]

Thanks for your replies. Glad to hear all was well for you Dotty with a similar measurement.
Hurdity of course it makes complete sense to time the scan right after the bleed and I wonder why on earth no one said anything to me about when to time it as it would save a lot of worry ... Also v helpful to know that endometrium waxes and wanes on hrt as it would in pre-menopausal times.
Scan was NHS and in view of the result I've been given an appointment at UCLH gynaecology which I'm told might include follow up scan and biopsy (though it would again not be in the post-bleed week)
I didn't realise the NHS letters in these cases were so graphic: "suspected gynaecological cancer"...
x

[laszla]

In case this of help to anyone taking much lower dose of utrogestan as I have been doing (100mg 7 days a month), my follow-up scan at UCLH was deemed absolutely fine. Lining was 6.5 (am more or less mid-cycle) so quite a but thinner than when I had previous scan the day before my period (when it was 10mm) and on the UCL results letter it describes this as "thin and regular" - I had read on here that a lower figure was considered thin but they told me that on HRT anything up to 7mm is considered thin (and of course it would be thicker in secretive phase).