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Menopause Matters magazine ISSUE 81 out now. (Autumn issue, September 2025)

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Author Topic: Womb scan - thickness on HRT and difference between U/S external and TVS  (Read 4550 times)

Hurdity

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Hi there folks

I thought members might be interested in the results of a womb scan I had recently.

For those who don't know me - background is I am late 60's, been on HRT for 15 years (approx 62.5 mcg) oestrogen patches), taking progesterone (vaginal utrogestan) 200 mg x 12 days approx on a long cycle (now 6 weeks instead of the usual 4) which gives a withdrawal bleed (not fun at my age!). All approved by my NHS GP.

I had a scan the other day. It was probably about 7-10 days since stopping the Progesterone so the lining should have been fairly thin, though because the bleed was short, the timing was later than I wanted - but it had been pre-booked estimating when the bleed would have finished.

By ultra-sound (U/S) abdominal scan the thickness measured 7.8 mm but surprisingly the transvaginal scan (TVS) which is considered more accurate showed it to be 9 mm. I was quite shocked by this - both how thick it was and the seemingly (to me) quite large difference between U/S and TVS.

However the sonographer said that for women on HRT with no abnormal bleeding they considered the cut-off point at which further investigation should be carried out, to be 10 mm whereas if not on HRT and if abnormal bleeding it would be 5 mm if I remember her correctly.

She could see no abnormalities - she couldn't find the fibroid I used to have (it was under 1 cm previously) and didn't see the need for further action though she suggested I contacted my GP to confirm normal endometrial thickness on HRT.

I had told her that my GP had recommended a course of norethisterone every now and again instead of utrogestan as I was on a long cycle - to "strip" the lining, should it have built up - but I've only done this twice, and not for several years, so I will probably suggest this to my GP. Ideally I would hope they might send me for another scan subsequent to this to check the lining had reduced but these days who knows?

Hurdity x

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Marchlove

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Thank you for sharing that information Hurdity, very kind and informative xx
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Lcgbw

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This is interesting. I am on intermittent prog and have regular scans.
My last measurement was 8mm (abdominal)which has been pretty consistent over the last few scans.
The sonographer  did say that my lining was even and showed no worrying signs.
I think up to a point it’s down to appearance of the lining rather than the thickness.
It is always a concern of mine and I have another US booked in April.
I find it so difficult on progesterone so don’t use it as often as I should :-|
How are you on norethisterone? Maybe I should consider trying a course……
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CLKD

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Morning Hurdity >wave<



How are you on norethisterone? Maybe I should consider trying a course……. your GP can prescribe this if necessary.  Your lining isn't thick enough to really worry about if your scans are regular.

It's about Trial and Error, finding which regime suits and going for scans when required. 
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Perinowpost

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Thanks for sharing Hurdity, very informative. My scans have shown lining consistently between 5 and 6mm, despite being on low dose prog. It is a consideration though what to do if it gets too thick, and something we all need to be aware of x
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Dotty

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Hi Hurdity I’ve suffered with post menopausal bleeding whilst on hrt 3 times now. When the lining was between 5mm and 10mm they performed a pipelle biopsy. Last time the lining was 11mm so I had a hysteroscopy because it was over 10mm.  All was ok thankfully xxx
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Sid

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Hi Hurdity

My GP insisted on a scan (she doesn’t like post menopausal women to take HRT sequentially) and the TV scan showed a lining of 7mm. My GP immediately sent a 2 Week Wait referral (even though I’d had no unscheduled bleeding). Interestingly enough, I checked the CCG referral guidelines and they stated that endometrial thickness of 10mm or less with no unscheduled bleeding did not require referral (unless the patient was anxious and wanted reassurance).  I was expecting the Gynae Dept to reject the referral because it did not meet their referral criteria but that didn’t happen. I recently had a hysteroscopy and biopsies - everything is absolutely fine. The only upside to the whole debacle is that the consultant offered to fit a Mirena when I had the hysteroscopy so (hopefully) no more monthly bleeds x
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CLKD

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Tnx Sid.

I read that :  pipelle biopsy : pippestrill (bats)  ::)

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tgisue

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Hi,

I had a biopsy yesterday and was wondering how long do results generally take?

Do you get a results letter or phone call?

Many thanks

Sue
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Sid

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Hi

Results came today - exactly 2 weeks after the hysteroscopy (and that’s exactly how long they told me it would take!) x
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Sid

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Sorry - meant to say I had a letter x
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Sid

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… and, CKLD, the whole debacle was, as you say, completely bats  ;D
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Hurdity

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This is interesting. I am on intermittent prog and have regular scans.
My last measurement was 8mm (abdominal)which has been pretty consistent over the last few scans.
The sonographer  did say that my lining was even and showed no worrying signs.
I think up to a point it’s down to appearance of the lining rather than the thickness.
It is always a concern of mine and I have another US booked in April.
I find it so difficult on progesterone so don’t use it as often as I should :-|
How are you on norethisterone? Maybe I should consider trying a course……

Hi there lcg...

Surprisingly well on the norethisterone considering how much I hate progestogens of any kind and how bad I felt on Evorel conti patches. The main adverse effect was the effect on blood sugar - I get reactive hypoglycaemia now and again (symptoms of very low blood sugar due to fast drop in blood sugar but not dangerously low levels as per diabetics). So that took me by surprise when I took lots of exercise and went from slightly hungry to weak, shaky, desperate for sugar andpouring with sweat! (Lovely!). I haven't taken it for a few years so I can't remember what the withdrawal was like but anyone should expect some sort of withdrawal symptoms when they stop any progestogen....anyway it's over quickly - I mean only 12 days followed by the withdrawal so bearable in the short term pretty much however you react I would say....

I haven't got around to doing an e-consult to get some but will do.

Hopefully if you want to go down this route you will be able to persuade your GP - my female GP who is part time and does all the gynae stuff ( not my regular GP) is very  clued up and will prescribe all sorts of things off licence...

Hurdity x

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Hurdity

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Morning Hurdity >wave<


Morning CLKD...!!!

Hurdity x
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Hurdity

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Hi Hurdity I’ve suffered with post menopausal bleeding whilst on hrt 3 times now. When the lining was between 5mm and 10mm they performed a pipelle biopsy. Last time the lining was 11mm so I had a hysteroscopy because it was over 10mm.  All was ok thankfully xxx

Thanks for that Dotty - glad all was OK. I have had no symptoms though (ie no abnormal bleeding) and she couldn't see any abnormalities but I will see what the GP says...

Hurdity x
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