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[Geminilady]

I’m wondering if anyone else has had endometrial thickening after having a mirena coil fitted. Previously I had been having bleeding in May after 2 years of continuous hrt gel and utrogestan with no issues. I was referred for a scan and all was ok, endometrium was 3.5mm, everything normal. Drs sent scan to hospital gynae to see if they wanted to see me but they said no and to try altering dosage of oestrogel to 1 pump and if that didn’t work try increasing back up to 2 and adding an extra utrogestan at night. None of these worked to stop the bleeding episodes so I was referred back to gynae for a biopsy.

In October I had the biopsy and the gynaecologist suggested trying a mirena coil as the progesterone component and it could be fitted whilst under the local anaesthetic for the biopsy. I agreed and I had bleeding for a few weeks on and off but it settled. Gynae report said on vaginal scan endo was 4.5mm, biopsy was normal. I went for my 6 week post coil fitting check at the beginning of December but the nurse couldn’t find the strings and eventually said she would have to send me for a scan. I had the scan this week but have had a phone call from go this morning to say the coil in in the correct place but my endometrium has thickened. When I asked what it was I was told it had thickened to 10mm. Dr now  referring scan result to gynae again for possible hysteroscopy. I’m now worried as to why it could have doubled in thickness in about 8 weeks.

Has anyone else had this issue with thickening even with a mirena? I’ve tried looking for info but can only find that the mirena thins the uterus not causes thickening.

Thank you.

[Teresa]

Hi,
First of all, don’t worry. I have had two ultra sound scans in the past three years, when I had bleeding episodes on HRT, both which showed thickened lining and fibroids and when I had a hysteroscopy, I had no lining ( atrophic) and no fibroids. I asked why the scan showed something completely different and was told they can be wrong or the womb can become distorted on a scan. You won’t know what is going on until the hysteroscopy. When I’ve had each hysteroscopy, they still haven’t known while I bled.
I too have had yet another episode of my bleeding, my third now,  after being on HRT for three years in total now. I’ve got an ultra sound scan this afternoon….I'm expecting the same thing - and I now have a mirena coil too ( before I was on utrogestan like you) I bled for a year after I had it fitted and I was told for some women, this can happen, so I didn’t worry.  The bleeding had stopped for the past 6 months…the very experienced female gynaecologist who fitted it told me that ‘women bleed on HRT’ like it was just one of those things. However, in our cases, we do have to get it checked out.
I take ultrasound scans of the uterus with a pinch of salt now, due to my experiences. So try not to worry and wait until the results of a hysteroscopy instead.

[Geminilady]

Thank you for your reply Teresa, that has eased my worries a little. It just seems such a big increase in a short time considering the mirena is supposed to keep it thinned. Everything seems to have gone haywire hrt wise since May, just getting me down now, it’s one thing after another. I feel like giving up on the hrt but will see what gynae say, I’ve seen on the nhs app that gp has sent for advice and guidance from them today but don’t know how long that could take.

Thanks again for taking the time to reply, and I hope things are ok for you.

[bombsh3ll]

Please don't worry, more than 90% of cases turn out to be completely benign.

If the nurse had been able to see the threads you wouldn't have even had this last scan, and sometimes it's a case of overinvestigation turning up incidental findings that then need further investigation.

It would also do you no harm to restart the utrogestan in the meantime given this did seem to be keeping your lining thin.

Another possibility which is unlikely but has happened is that someone fitted a copper T instead of a mirena, which contains no hormones and is unsuitable for endometrial protection.

[joziel]

Gemini, did you try utrogestan vaginally? Or only orally? Often it is absorbed much better vaginally or even rectally.

Vaginally is more common in the UK but it is used rectally a lot in the US. If the Mirena isn't working to keep the lining thin, you could try that.

[Geminilady]

Please don't worry, more than 90% of cases turn out to be completely benign.

If the nurse had been able to see the threads you wouldn't have even had this last scan, and sometimes it's a case of overinvestigation turning up incidental findings that then need further investigation.

It would also do you no harm to restart the utrogestan in the meantime given this did seem to be keeping your lining thin.

Another possibility which is unlikely but has happened is that someone fitted a copper T instead of a mirena, which contains no hormones and is unsuitable for endometrial protection.

Thank you, I’m trying not to worry. I’m taking the fact that the biopsy taken at the time of the coil fitting was normal with no malignancy as a reassuring sign. I think it was definitely the mirena that was fitted as I was given a card with its specific number on it.

[Geminilady]

Gemini, did you try utrogestan vaginally? Or only orally? Often it is absorbed much better vaginally or even rectally.

Vaginally is more common in the UK but it is used rectally a lot in the US. If the Mirena isn't working to keep the lining thin, you could try that.

Thank you for replying. No I didn’t try utrogestan vaginally, only orally as advised by gynae to gp. I’ve questioned with the drs surgery today whether to start taking a utrogestan as well as I still have a few left from before the mirena was fitted,  but had a reply back with no answer to my question other than I have another phone consultation booked for 3rd Jan, as they should’ve had advice and guidance back from gynae by then.

[joziel]

I think... get it checked out and make sure it's nothing to worry about and when you figure out you just have the bleeding to deal with, ask to increase utrogestan/progesterone as well as the Mirena.

You can then experiment with taking it vaginally or rectally because it's the same utrogestan capsule however you take it...

[Geminilady]

Thanks joziel that’s what I’m going to do. I’ve decided I don’t want to start messing around before hearing from gynae as I’d rather they see things as is. Thank you for your reply, I’ll update the thread when I’ve found out more, in case it helps anyone else in the same situation at some point.