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[Ljp]

Hi,
Here’s my story, I’m 60, been on estrogel 3 pumps and mirena coil since 2015. Also estring and intrarosa for GSM.
Started Testogel in 2019.
All been ticking along nicely, second coil fitted in January 2020, no problems.

Coil needed replacing in January this year, couldn’t get appointment until Feb, so I was put  on utrogestan vaginally as a precaution, and a trans vaginal ultra sound scan booked to check lining. Had scan in 4th Feb, lining was 5mm.

Appointment for coil replacement was Feb 7th, Dr removed old coil and my cervix went into a spasm, she tried twice to insert new coil but couldn’t, so I had to wait until her next clinic a month later in March to try again, in the mean time I was using utrogestan 100 nightly internally.

Had my new Mirena fitted on 5th March, was quite uncomfortable and crampy and bled afterwards, advised to use utrogestan for a further three nights until coil settled.
Bleeding stopped overnight, but when I stopped the utrogestan within two days I had dull achy cramps and bleeding started again. That was on the Tuesday, I called the Dr on the Friday and she advised me to use utrogestan again to help stop the bleeding, she also booked me to see nurse to get strings checked, and requested another trans vaginal ultra sound to be booked to check coil placement.

I used the utrogestan for a further 10 days, the bleeding stopped, it did start up a bit when I stopped, but all seemed ok and has settled.

I had my scan on Sunday, she asked if I was on hrt I said yes, she said all looked fine.
Now I’ve just checked on the nhs app and seen results, says to discuss with Dr, I have an appointment on Thursday anyway, but wasn’t expecting to see that according to the scan my uterus lining is now 5.9mm with is .9mm more than it was in Feb!

I’m really anxious about this and can’t understand why, unless the month without the coil and just using utrogestan wasn’t enough to stop the increase in lining.
But the fact I was bleeding after having the new Mirena would surely help reduce the lining?
I’m wondering whether to use utrogestan again to see if it will reduce it? Just feel so anxious it might be something 🤯
It did say no sign of polyp or mass or fluid

Any reassurance/help please? Apologies for long post 🤦‍♀️

[bombsh3ll]

0.9mm is within the margin of error for measurement of a structure on ultrasound.

If a different operator had done it they might have got 4.8mm, or 6.2mm.

I would not regard this change as clinically significant.

Worst case, because it is above 4mm, which is the normative value for postmenopausal women NOT on hormone therapy, and guidelines haven't been updated to recognise that this isn't always the case for estrogen replete women, you may have to get a hysteroscopy and biopsy.

[Ljp]

Thank you so much, that has made me feel a bit better x

[Ljp]

0.9mm is within the margin of error for measurement of a structure on ultrasound.

If a different operator had done it they might have got 4.8mm, or 6.2mm.

I would not regard this change as clinically significant.

Worst case, because it is above 4mm, which is the normative value for postmenopausal women NOT on hormone therapy, and guidelines haven't been updated to recognise that this isn't always the case for estrogen replete women, you may have to get a hysteroscopy and biopsy.

Would using utrogestan help shed any extra lining?
I get confused as in my mind adding extra progestin should help reduce lining? but it was prescribed for me a few weeks ago to help stop the bleeding I was experiencing from the
coil being replaced. I don’t j derstsnd how that works

[bombsh3ll]

I wouldn't bother with micronised progesterone if you're not bleeding.

Using that alongside a Mirena is like flying a 737 and flapping your arms as well.

Your lining is absolutely marginally above a normative value taken from an inappropriate comparator population.

It is likely to atrophy further over time with the strong progestin in the IUS.

To put it into perspective, a cancerous endometrium typically shows up with a thickness of 15 or 20mm.

IF, and it is a big IF, you were harbouring anything sinister, adding micronised progesterone at this point would not change the outcome.

[Ljp]

Thank you bombsh3ll
Can I ask are you a medical professional? You seem incredibly knowledgeable 😊
I’d like to be confident to quote some of this with my GP later x

[SundayGirl]

Unlikely you'll get an answer to that question Ljp.