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[Sfifties]

Hi was wondering if anybody can shed some light regarding bleeding in menopause .

have been on conti regime of utrogestan nightly and 3 pumps of oestrogel for a bit more than 6 months.
being bleeding almost every 2 weeks apart from the first month on hrt.

i have had a scan and my endometrium thickness is 3mm ,this was 6 days ago and today i am bleeding again ,i thought that the bleeding was caused by a thickened endometrium so the bleeding was the body way of shedding it  but that doesn’t explain me bleeding only 6 days after a scan showing a thickness of 3mm.
i am awaiting a Gynaecologist appointment in the next few weeks as during my scan some anechoic fluid was found in the endometrial cavity .
i am very confused as before starting hrt no abnormal bleeding occurred at all so i am certain that this bleeding is caused by hrt but why , what is causing it if scan seem ok in thickness?
obviously now starting worrying too because possibly the fluid will need to be examined and more invasive procedures performed.
i have in 2 weeks gone through a coil removal , a failed attempt to have a smear test ( not possible because of some blood in uterus although wasn’t bleeding actively) a transvaginal scan that took 20 min doing and now a gynaecologist appointment and possibly more …

has anyone gone through something similar ?
thanks

[sheila99]

How much blood and what colour? Full blown period type of bleed or just a little/spotting? If you had fibroids or polyps would they have told you or would you have to wait for the doctor? Any symptoms of VA as that can bleed? Was the mirena the prog part of hrt or were you on something else? Usually a mirena is the best option to prevent bleeding.

[Sfifties]

Hi sheila99 ,bleeding are full on around 4-5 days each time.
The report mention a small fybroid just above 1cm and no polyps.
The main cause for referring remains the bleeding and the report mentions some anechoic fluid found that i guess will need to be examined too.
No symptoms of va , the coil i had removed was a copper intrauterine coil that i used for years after the birth of my child and had to be removed 1 year after no periods.
What puzzles me is the perfect thickness of 3 mm and still bleeding?
I am aware that it could be serious ( cancer) but somehow i am dubious because before starting hrt i never bleed erratically my periods stopped and the flushes started and the bleeding started with hrt .
My Gp seemed reluctant to prescribe more utrogestan ( 200 mg instead of 100) as i am wondering if that could settle the bleeding ?
Has anyone been  successfull in stopping bleeding by upping utrogestan in a conti regime ?
She will not prescribe Provera .

[Nas]

The fibroid could be the cause of the bleed?

If you were under Chelsea and Westminster, they would advise upping the utrogestan to 200 nightly, to see if that controls the bleeding. My specialist would recommend trialing the coil.

I would think it’s hormonal stimulation of the womb, caused by HRT, if you didn’t have this before. I have the same on the 75 patch. My bleeds were 2 weeks apart and are now monthly, with full on PMT and and cramps.

All my scans have revealed a thin lining and no sinister findings. Bleeding can be a side effect of HRT unfortunately.

[Sfifties]

Thank you Nas ,
I am Trying not to worry too much although this is causing anxiety and hoping is just a side effect of hrt and eventually will find a way to stop it.
I have been referred to a menopause clinic around 3 months ago but not yet received a letter or anything with an appointment date.
My understanding is that this Gynaecologist referral should be happening in the next couple of weeks.
But not sure what to expect, do u know if after investigating the scan finding the Gynacologist will be able to tell my Dr how to proceed ( ex up utrogestan) or i will need to wait for the menopause clinic appointment as my Gp will not change my hrt without a specialists advice ? Thanks

[Nas]

It’s unlikely gynae will be able to advise your GP on how to proceed, as that is not their role. However, they could make recommendations. So for example, my gynae wrote to my GP to say I was a good candidate for the coil, that’s it. But I’ve had breast cancer, so my GP won’t do anything without a letter from the specialist anyway!

I think you will have to wait for your appointment. Unless you trial utrogestan cyclically? That way you may get a lighter more predictable bleed? Upping the  dose will be a suggestion that only a specialist will make  as it’s licensed for 100 nightly. 

[clareabelle1]

Just to answer one question. I had the same bleeding after coil removal.
Menapause clinic put me on 200 mg Utrogeston conti.
No more bleeding!!!
2 estrogen pumps daily.

[Nas]

clareabelle, did the coil stop any bleeding before it was removed?
I’m due for a fitting in a couple of week and am hoping it sorts the bleeding!