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[Harmony]

Hello all. I'm a long time member of the forum, but haven't posted for ages! I've been having some brown discharge for a while, and also have mild period type pain sometimes. I'm not on HRT. I was referred on the two week pathway, and have had a gynae consultation, transvaginal ultrasound and a follow up appointment. Fortunately nothing was found on the scan, and my womb lining is very thin at 1.4mm, so thankfully I don't need a hysteroscopy.

The consultant said the bleeding could be a blood vessel bleeding, due to vaginal atrophy, and to request oestrogen cream from my GP. I'm wondering if you can have vaginal atrophy without knowing, as I don't have any (other) symptoms as far as I'm aware, and still produce sufficient lubrication when it's needed! Just wondering if anyone else has had similar very light post meno bleeding or spotting with no concrete reason found? Or does anyone know if a very thin endometrial lining can cause this?

[bombsh3ll]

Absolutely a thin atrophic uterune lining, as well as an atrophic vagina, can cause bleeding. This is usually light and irregular.

Your scan showed a very thinned endometrium.

This is consistent with too little estrogen and/or excessive progestogen for the amount of estrogen taken.

It is also possible, in fact probable on NHS doses of estrogen, that you have some degree of vaginal atrophy. This can occur without any other symptoms.

Advice would depend on on multiple factors such as presence of systemic symptoms, therapeutic goals eg osteoporosis prevention and what treatment you are currently taking.

[Harmony]

Thanks very much for your reply, that's  reassuring. I'm not taking HRT, so have been more concerned than if I was, as there's no outside/definite cause for the bleeding. I hope the oestrogen cream will stop it. The consultant said to ask to be referred again in 6 months if it hasn't.

[CLKD]

During my menstruating years I would bleed heavily with excruciating pains for 6-10 days followed by a 2 day break.  Then I would have a brown staining for 2-3 days, normal for me so never concerned.  Probably due to not enough hormone to push the rest of the bleed through.  I would also have intense itching high up with the staining.

[Dotty]

Yes I was told that my post menopausal bleeding was caused by atrophy in the vagina or womb. I am on hrt but my womb lining was very thin.

[Harmony]

I don't remember ever reading about atrophy/a thin womb lining causing bleeding before. When I asked the consultant if that could cause the cramping that I've been having, she didn't say anything in reply.

I collected the estriol 1mg/g cream yesterday, and am somewhat dismayed that the dosage she prescribed is different from that given in the leaflet. She said to use it once a week after the loading dose, but In the leaflet it says to use it twice a week on an ongoing basis. I'm wondering if this half dose is likely to do much, and imagine that it may not give a true result if it doesn't stop the bleeding. I'm sure I've read posts on here that some women with severe vaginal atrophy use it every day..I know the cream only contains a tiny amount of oestrogen as it is.