Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[pepperminty]

Hi Ladies ,

Following on from my previous post about having a private scan on my womb.

 I have had the scan and the results have worried me. She said that there is a polyp and a patch of adenomyosis with a feeder vessel. I do get what can only be described as intermittent groin pain. Which I live with as not all the time. My lining is 8mm, just after my bleed- so ok.
She suggested I get a referral  for further investigation as they like to remove polyps . 
And that you can't do anything about adenomyosis.

I don't know what to do. I am scared they may try to take my HRT away if I contact my GP.

Also I had an horrific experience with my last hysteroscopy under general Anesthetic - they traumatised my cervix, ( its in the notes, i have been advised) caused pain and constipation and bowel issues for months and I was violently sick for 24 hours - even though I told them Anesthetic makes me very nauseous.  I had a polyp then.
Do I just leave well alone and not tell the NHS?
I also want to try continuous combined HRT - is this a good idea?
Should I lower my dose of current HRT a bit? I am on a medium dose.

Any reassurance and advice is welcome.

At least my lining is within normal limits .


PMxx

[CLKD]

This is your body so you don't have to agree to any procedure unless U R absolutely sure about it.

Make a list of your worries to discuss with your GP and then if necessary get a referral to the appropriate dept., again with the list.  If necessary take some1 with you.

As for HRT regime I can't comment, hopefully some1 will B along.

[pepperminty]

This is your body so you don't have to agree to any procedure unless U R absolutely sure about it.

Make a list of your worries to discuss with your GP and then if necessary get a referral to the appropriate dept., again with the list.  If necessary take some1 with you.

As for HRT regime I can't comment, hopefully some1 will B along.

Thank you, I do have an appointment with the menopause clinic in the next few weeks,  so I could bring it up then.

PMxx

[bombsh3ll]

I wouldn't lower a therapeutic dose of estrogen but I would think about increasing the progestogen given the lining was 8mm post bleed.

Which brings me to the second point of why you are bleeding at all? This is 2025 not 1975 and we have had the tools to avoid both menstruation and iatrogenic withdrawal bleeding for several decades.

A continuous regimen with either a higher dose of micronised progesterone or a synthetic progestin with higher potency would be my choice from the point of view of not needing further invasive investigations.

If you don't want a hysteroscopy and feel that disclosing these benign findings to the NHS would potentially compromise your access to treatment, then having a further private scan to monitor in 6 months would be reasonable.

[pepperminty]

I wouldn't lower a therapeutic dose of estrogen but I would think about increasing the progestogen given the lining was 8mm post bleed.

Which brings me to the second point of why you are bleeding at all? This is 2025 not 1975 and we have had the tools to avoid both menstruation and iatrogenic withdrawal bleeding for several decades.

A continuous regimen with either a higher dose of micronised progesterone or a synthetic progestin with higher potency would be my choice from the point of view of not needing further invasive investigations.

If you don't want a hysteroscopy and feel that disclosing these benign findings to the NHS would potentially compromise your access to treatment, then having a further private scan to monitor in 6 months would be reasonable.

Hi Bombsh3ll,

I am on Femosten 2/10 . so i would not be able to have a higher dose of progesterone other than what is is the continuous Femosten regime. I am not sure about changing completely to another type of HRT at this time. 

Is 8mm thick then after a bleed? I had a shorter bleed than normal this month, with less shedding. Some months the bleed is 5 days and others 7 to 8. I thought I would reduce slightly before I started the continuous ( as I use zumenon and Femosten together which adds up to the 2/10 as the dygesterone is still the same amount )

PMxx

[bombsh3ll]

8mm is a little high after a bleed but not worryingly so.

What dose of estradiol are you adding to the femoston?

If dydrogesterone works well for you I would suggest making up your dose with additional femoston rather than estradiol alone as you are potentially taking more estradiol than that dose of progestin can cope with.

If you are happy spending every 4th week bleeding then you could add femoston 1/5, or if you are taking 3mg estradiol daily and want a continuous regimen you could achieve this with 3* 1/5 femoston daily (however this could get expensive).

If you are not yet postmenopausal it may be worth considering a combined oral contraceptive pill taken continuously.

This is more likely to tick all the boxes in terms of menstrual suppression, endometrial protection and a therapeutic dose of estrogen in a more convenient and economic way, whilst maintaining the convenience and reliability of a pill.

[VioletAquarius]

Hi pepperminty

From what i understand polyps can lead to cancer if not removed.

I also understand that it's 5mm and under for a normal womb lining.

This is what the doctors told me at my laparoscopy.

Would and could you have a laparoscopy under local, so you're not sick?

[bombsh3ll]

The 4mm endometrial thickness guideline is based on postmenopausal women not taking hormone therapy.

There have been no normative values agreed on by relevant professional bodies for individuals taking hormone therapy, especially those who are still cycling.

The vast majority of polyps are benign, and as UK women do not get regular gynaecological screening ultrasounds millions of us are walking around with polyps that we don't know about and will never cause a problem.

A laparoscopy also cannot tell you anything about the inside of the uterus. You would require a hysteroscopy.

Given that this can be traumatic, and having a general anaesthetic shouldn't be undertaken lightly, it is entirely reasonable to choose ultrasound monitoring vs an invasive procedure for a lesion with a statistically very low risk of malignancy.

[pepperminty]

8mm is a little high after a bleed but not worryingly so.

What dose of estradiol are you adding to the femoston?

If dydrogesterone works well for you I would suggest making up your dose with additional femoston rather than estradiol alone as you are potentially taking more estradiol than that dose of progestin can cope with.

If you are happy spending every 4th week bleeding then you could add femoston 1/5, or if you are taking 3mg estradiol daily and want a continuous regimen you could achieve this with 3* 1/5 femoston daily (however this could get expensive).

If you are not yet postmenopausal it may be worth considering a combined oral contraceptive pill taken continuously.

This is more likely to tick all the boxes in terms of menstrual suppression, endometrial protection and a therapeutic dose of estrogen in a more convenient and economic way, whilst maintaining the convenience and reliability of a pill.

Hi bombsh3ll,

Thanks for replying. I am a tad worried. I am taking femosten 1/10 sequi with an extra daily Zumenon which is the same estrogen as in the Femosten. This brings me up to 2/10 Femosten equivalent as the Dydrogesterone  is the same amount for both 1/10 and 2/10. I have been advised that this is ok for me as I can lower the estrogen if I want to by cutting the Zumenon in half ( I found increase did not suit me in the past) .  I have been on the increased amount for about 6 months now. Previously I was on 1/10 with half a Zumenon top up - so not reaching the 2/10 amount that I am on now. 

So I guess going up to a medium dose caused a thickening and maybe encouraged the adenomyosis? So I could lower the dose of estrogen  a bit. My  estrogen levels went from 250 ish to 500 ish when I increased last year.

I wanted to trial continuous, as I am tired of getting a bleed .

I could take Femosten conti  1 mg estradiol & 5mg dydrogesterone daily plus femosten conti low dose Estradiol 0.5mg, Dydrogesterone 2.5mg daily together.
It is reassuring as you say loads of women are walking around clueless about if they have a polyps. I had one removed a few years ago which was benign .

I am just not sure whether to tell my menopause clinic? If I have any investigations I do have to have general anesthetic. So not keen on that.

PMxx

[bombsh3ll]

Ok that makes clinical if not economic sense that you are essentially taking the equivalent of femoston 2/10.

I thought you were taking femoston 2/10 AND additional estradiol.

Nonetheless I would consider increasing your progestin, eg taking 2* 1/5 daily so you're getting 10mg of dydrogesterone every day rather than 2 weeks out of 4.

This should thin down your lining further.

Me personally I would choose to monitor the polyp privately - obviously if it is evolving or showing any suspicious characteristics this would be a different story but if it remains static I wouldn't rush to an invasive procedure.

There is harm from over diagnosis and over treatment of benign conditions, and unfortunately women can end up over a barrel with the NHS effectively looking for reasons to withdraw hormone therapy unless you submit to invasive procedures for something that in all probability they would agree was reasonable to leave alone were you not on hormone therapy.

[pepperminty]

Ok that makes clinical if not economic sense that you are essentially taking the equivalent of femoston 2/10.

I thought you were taking femoston 2/10 AND additional estradiol.

Nonetheless I would consider increasing your progestin, eg taking 2* 1/5 daily so you're getting 10mg of dydrogesterone every day rather than 2 weeks out of 4.

This should thin down your lining further.

Me personally I would choose to monitor the polyp privately - obviously if it is evolving or showing any suspicious characteristics this would be a different story but if it remains static I wouldn't rush to an invasive procedure.

There is harm from over diagnosis and over treatment of benign conditions, and unfortunately women can end up over a barrel with the NHS effectively looking for reasons to withdraw hormone therapy unless you submit to invasive procedures for something that in all probability they would agree was reasonable to leave alone were you not on hormone therapy.

Thank you,

 I am very conscious of taking the correct dosages of progesterone.

Yes I think i will be going on to the conti regime . The choice according to the treatment tabs above are either taking 1 mg estradiol & 5mg dydrogesterone daily, which I could double giving me the 10mg of Dydrogesterone daily.

Or taking 1 mg estradiol & 5mg dydrogesterone and the lowest dose of Estradiol 0.5mg, Dydrogesterone 2.5mg, which would give me a slightly lower dosage of it all together.

I am hoping that it suits me in the long run. I think I may mention the polyp on my next appointment with the meno clinic and just strongly state that the last polyp was ok and that  I would prefer no invasive treatments just monitoring- and the fact that no one would be any the wiser if I hadn't had a private scan. Also I suspect they won't go by a private scan anyway.
I think the continual P dose will help the adenomyosis?

Thanks again for guiding me through , as it is always hard to be objective about your own health - meno panic sets in!

PMxx

[VioletAquarius]

Thanks Bombsh3ll,  I meant my hysteroscopy,  not laparoscopy .

[Ebonybones]

My
Poly made my lining look thick on the ultrasound it was 6mm I think and the poly was 10mm