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[buffy26]

My GP advised me to increase from 1 to 2 Utrogestan because I was on 4 pumps of Oestrogel, this was based on the new Nice guidelines. I was a bit concerned that I had been on insufficient ratios too long. When I raised this she said I think you should be scanned again once we have sorted other separate health things out. I then saw on my NHS app her comments post the appointment, If patient bleeds then send for scan.  I had a thickened lining 2 years ago 7mm and a bleed whilst starting HRT but it all seems to have settled. As I had Endometriosis since 13 and had been insufficiently covered on a relative lower than should be progesterone dose for a good while, I am a little concerned. I dont wish to make a hoo hah yet about not beig scanned as I am not bleeding. Just wondered if anyone knows, is the only sign of anything 'c' word related bleeding or should I be pushing for that scan because of history and the higher dose of gel for some time?

On a positive note, the increase of progesterone seems to be significantly helping with brain fog and sleep!
Ps/ I am also using Blissell and Vagifem every night for VA

[applejack]

Hi Buffy

not a doctor but in my experience it's the bleed that seems the main sign.

I had a lot of issues with this - including two hysteroscopies, dozens of scans etc - and they only seemed to ask me about bleeding and not any other symptoms at all.

I'd push for the scan anyway if they said you should have one, especially if you've had endometriosis in the past.

[buffy26]

Thank you for your reply applejack

Also had a hysteroscopy. Its a worry isn't it. I know that some people have bled with tiny polyps that can hide deep in the womb and also friction from sex, its so hard to feel settled. I read a clinical paper last night which talks of rates of cancer in non bleeding cases. I found it a bit tricky to follow as it was quite a long document but have taken from it that there are about 15% of cases where patients hadn't bled. Its made me want to be scanned for definite now.
read.https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.1704#:~:text=If%20an%20endometrial%20thickness%20of,endometrial%20measurements%20above%20this%20threshold.

I must have been quite tired when I found this article, I have read it today and there is no reference to HRT. I thought I would leave it on here though as it may have some value to someone.

This is the article I read if anyone is interested in reading it. My concern is I am on HRT x 4 pumps and I have the history of endometriosis  I am 62 in a few months

[sheila99]

I don't think you're at any particular risk though a scan will put your mind at rest. They've only recently changed yhe guidelines so presumably there weren't many women for whom the old dose was insufficient. As you have endometriosis would you get pain if it was building up?

[CLKD]

Also reading Clinical papers etc. can be hugely problematic even for Scientists which is why I handed Chris Van Tulkeans book about 'ultra processed foods' to DH - he waded through it with interest and read those bits that I could understand  .  Even when typing many Papers etc. I tried not to understand what I was typing .......

buffy26 - do U remember the Authors and Sponsors of the Paper?

[buffy26]

I don't think you're at any particular risk though a scan will put your mind at rest. They've only recently changed yhe guidelines so presumably there weren't many women for whom the old dose was insufficient. As you have endometriosis would you get pain if it was building up?

Hi Sheila99

Yes the guidelines were only recently changed. I am sure there are a few endometriosis sufferers who would also be a bit concerned.
I used to get pain when I was having active periods and during mid-cycle. Just before my periods stopped altogether, I bled heavily and the pain was intense like it had been for years prior. I had 10 years pain free from 45 onwards after trying alternative therapies but it came back weirdly just before the end of having periods, as a final goodbye and remind me how god damn awful it had been!! I am seeing a gynae in a couple of months I shall see what she thinks as well.

[Penguin]

Thank you for your reply applejack

Also had a hysteroscopy. Its a worry isn't it. I know that some people have bled with tiny polyps that can hide deep in the womb and also friction from sex, its so hard to feel settled. I read a clinical paper last night which talks of rates of cancer in non bleeding cases. I found it a bit tricky to follow as it was quite a long document but have taken from it that there are about 15% of cases where patients hadn't bled. Its made me want to be scanned for definite now.
read.https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.1704#:~:text=If%20an%20endometrial%20thickness%20of,endometrial%20measurements%20above%20this%20threshold.

I must have been quite tired when I found this article, I have read it today and there is no reference to HRT. I thought I would leave it on here though as it may have some value to someone.

This is the article I read if anyone is interested in reading it. My concern is I am on HRT x 4 pumps and I have the history of endometriosis  I am 62 in a few months

That paper was published in 2004, so 20 years ago! If that's all you found with a % of non bleeding cases, then it is really unlikely to be a thing. It would have been studied further amd more recent papers published by wider authors if it was.

[buffy26]

I should have gone to specsavers!
No its not all I could find, I haven't looked further, which is just as well🙄

[Penguin]

I should have gone to specsavers!
No its not all I could find, I haven't looked further, which is just as well🙄

Yes indeed, but if there was anything more recent it'd have popped up first amd been all over the place plus incorporated into guidance and used! Please don't look further x