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[Eviepf]

I had a subtotal hysterectomy (so, retained my ovaries and cervix) 11 years ago. I've been using Vagifem for quite a few years now and, since a couple of years ago, have added Ovestin on the vulval area.

My GP has contacted me to say that I need to undergo a 'progesterone challenge' in the form of 10 days of oral medroxyprogesterone (I think it was - a long name, starting with 'm'!) to see if it provokes a bleed. If it does, then I'll need to go onto regular Utrogestan. This has evidently been suggested by a hospital specialist (gynae, I assume). It's really surprised me as it has come entirely out of the blue. I can only assume it's a general edict-type thing - I can't imagine it's personal to me, as the only contact with the hospital I've had in recent years about anything meno-related is for VA-related symptoms, and even that wasn't recent. I was vaguely aware of this as a 'thing' but, as I say, feel slightly blindsided as it is so unexpected.

Has anyone else experienced this? Just wondering, if it IS a new, general thing, whether others have had a similar message? And I'd be grateful if anyone who's been through the process could let me know what their experience was like. Thanks in advance.

[CLKD]

Is this missive from your Consultant?

Is this idea going to garner income for the GP Surgery (as do statins?)

I would send a message to Dr Curry on here, for which there is a fee.  Or look at the Menopause list: pink banner at the top of the page.  See if there is anything mentioned.

Then let us know ;-)

[Taz2]

Where is the bleed expected to come from exactly?  Are you up to date with your smear tests?

Taz x

[Eviepf]

Thank you CLKD and Taz2.

I don't have a Consultant at the moment, which is one reason why I'm confused! It's quite a long time since I've been seen at the hospital and was discharged by the two departments involved (gynae and dermatology) - no ongoing treatment by either of them. I did wonder (as CLKD suggests) if there is an income involved for the GP surgery for doing this, which is why I wondered if anyone had received a similar message recently.

The bleed (if any) would apparently come from any endometrial tissue which had remained after my hysterectomy - apparently it's a risk if the cervix is retained. I've had regular smear tests since the hysterectomy and am up to date - the most recent was around 18 months ago and was the last routine one I'll get (aged 64 at the time). When the GP rang me and started talking about my cervix, I thought that maybe it was a smear test issue, but no...

Good suggestion to message Dr Curry. Before I do, I'm going to try to speak to the GP next week. I was so surprised by what she said that I never thought to ask what exactly had initiated this.

I will report back!

[CLKD]

Were you suffering with endometrial problems?

Let us know how you get on.  Interesting quandary.

[Taz2]

If you've been on oestrogen only HRT  but retained your cervix then there is sometimes concern that there may still be some endometrial cells present. Smear tests are obviously very important and these should continue even after the usual cut-off date if you are using oestrogen. Some women are given progesterone soon after the hysterectomy to check whether there is any bleeding indicating the presence of cells. This might help (scroll down to Sub Total Hysterectomy) https://www.menopausematters.co.uk/aftermeno.php

Taz x

[Eviepf]

Reporting back, as promised.

Thank you Taz2 for the link. I had recently remembered that I *was* vaguely aware of this and (it turns out!) had even asked a question on MM a few years after my hysterectomy because I was concerned. I blame meno brain for the fact that I had since forgotten.

Anyway - have just had a conversation with my GP... She asked me what were my plans HRT-wise, and I thought 'blimey - she's forward-thinking - she's going to ask me if, at the age of 65, I want to go on to systemic HRT' - but no, as it turned out. She thought that I was 'already' on systemic HRT, having (I gathered) become confused by the fact that I use two types of oestrogen - Vagifem and Ovestin, despite the fact that both are topical. I did try systemic for a while many years ago (hence my concern referred to above) to try to get VA under control, but was having such bad side effects, and no good effects on the VA, that I stopped within a year.

I wouldn't expect the GP to remember me out of all the thousands of other patients but, given the fact that she'd apparently gone to the trouble of emailing two consultants to ask for advice before contacting me out of the blue, I'm surprised she hadn't looked more closely at my records. The last prescription for Oestrogen gel I had must have been around 7 years ago and she actually prescribed the Ovestin last year after an email exchange we'd had about me wanting to try it on the vulval area. My gob was well and truly smacked, honestly.

The upshot is - as I'm not on systemic HRT, there's no need for me to do anything - all cancelled. Had I not queried it though, I could already have been taking the medication. I'm so glad I asked.

(If anyone is interested in current thinking on the whole progesterone challenge thing, it seems that of the two consultants she asked, one said it wasn't necessary and the other said it was probably worth doing, so still no concensus, it seems).