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[Hyposteo]

I’m so pleased to have found this forum with such knowledgeable and helpful people, thank you! 

I’ve read a lot of the posts and have been reassured to see that post-menopausal bleeding on HRT is not the shocking doom-laden symptom the NHS would have us believe.  But I’m in a lot of pain with it, which other people don’t seem to have.

I’m 72 and have been on HRT for 3.5 years following a diagnosis of osteoporosis.  It has changed my life in several other ways too so I'd not want to stop it.  I use 2.5 pumps of oestrogel, (also testosterone) and was prescribed 100mg Utrogestan.  I couldn’t swallow it so was told to take it vaginally but only every other night. 
All was well until a couple of months ago when I forgot the Utrogestan one night so took it the following morning.  The bleeding and pain started soon after and lasted five or six days.  30 days later the bleeding (not much) and pain (a lot) started again and I’m now on the 14 day pathway.  I’ve had the transvaginal ultrasound which showed thickening of the womb lining (I was not told by how much) and a couple of cysts (thought to be benign) on the ovaries.  I’ve just had the CA125 blood test and awaiting result. 
The bleeding has stopped now but the pain has not (day 8 now).  The GP gave me a prescription for stronger pain killers which may be helping a bit though hot water bottles help more.  My periods used to be dreadful (so I was on the pill for 20+ years) but I really thought I’d left all this behind a couple of decades ago.  Has anyone else had this amount of pain, when does it stop and should I be worried?

[CLKD]

   I had excruciating pains with large clots for years so was relieved when periods stopped after several years of waxing and waning.

Does the pain relief help at all, I took 'feminax' for many years: the idea being to begin the tablets 2 days B4 a period was due ....... to relax the muscles? 

I also took The Pill to ease symptoms, even after being sterilised. 

[bombsh3ll]

If you have always had painful menstruation, you are more likely to experience pain with progesterone withdrawal bleeding as well.

It may be that you have had undiagnosed endometriosis all this time, or are simply unlucky to have more pain with uterine bleeding than others.

Having banked 20 years' worth of risk reduction for ovarian and endometrial cancer on the combined pill (which is also my personal goal) you are actually in a relatively favourable position now.

There is a clear history of undertreatment with progesterone- guidelines recommend 100 mg every night vaginally not alternative nights, and bleeding precipitated by a missed dose.

Therefore if you start taking it in accordance with guidelines, this is likely to eradicate the bleeding, and with it the pain.

[Hyposteo]

Thank you so much bombsh3ll, that is immensely reassuring and your expertise greatly appreciated.  Though I'm pretty cross with a well-known private clinic for prescribing the wrong dose of progesterone.  And GPs haven't picked it up either since the NHS took over the prescription, at least until I went last week when GP said straight away I need to take every night.  I will decline the suggested invitation to a biopsy if it comes, I don't need more pain!

Like you CLKD I had excruciating pains and clots when I came off the pill and was so relieved when it all stopped.  Which makes it all the worse going back to it 20 years later.  Painkillers didn't touch it then, or now. 

It's great to find out the pill was a protective factor when I always assumed it was going to do at least some damage.

Thank you again.