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[Cosmos]

I'm 63 and learning, 15 years ago I was desperate for help and my GP flatly refused HRT because of the risks.
I had a tiny bleed last year and after a scan and pipelle biopsy it was a caruncle.
I discovered I had GSM and had to ask for help with this so I'm on vagifem 3x a week.
I then learnt there are so many benefits to HRT and asked to give it a try. I'm able to sleep for the first time in years the flushes have gone plus the swelling arthritis in my hands improved.
I'm on Evorel Conti and had intermittent bleeding, I was told to persevere for 6 months, month 7 still spotting for a couple of days every two weeks, I understand it's an imbalance.
This is my issue, pretty sure I'll need a further scan and I'm absolutely terrified of needing a hysterectopy.
I'd like to try oral progesterone body identical but they are capsules and I can't swallow, if I were to just stop this breakthrough bleeding it'd be fine...
Anyone in a similar position??

[CLKD]

  your GP was years behind ! no woman should have to suffer with symptoms.

Using VA treatment every night is OK as it's such a tiny amount of active ingredient, if 3x a week is OK then that's fine, if symptoms niggle up the nightly insertion for 2-3 weeks.  As our hormone levels drop we may need to do a reload regularly.

[KittyKats]

I also have bleeding and spotting on Oestrogel and Utrogestan but I take the Utrogestan vaginally. I have the dysphagia too so not sure I could even manage with the capsule!! I've been on HRT 5 years and I am trying to cut down. My consultant recommended the Evorel Conti but I've never tried it.

I am also terrified as I have been told I need a hysteroscopy. What was the pipelle biopsy like? Is it easier than a hysteroscopy?

[bombsh3ll]

I agree micronised progesterone is worth trying - actually there are multiple reasons for taking it vaginally, it is delivered more locally to the uterus avoiding first pass metabolism in the liver, and anecdotally better for controlling bleeding this way than when taken by mouth.

The vaginal route is a great option for those who can't take oral for any reason.

Additionally using a separate estrogen and progesterone means you can alter the dose of each individually according to your needs, and are not stuck with a fixed combination that offers no flexibility.

[Cosmos]

I also have bleeding and spotting on Oestrogel and Utrogestan but I take the Utrogestan vaginally. I have the dysphagia too so not sure I could even manage with the capsule!! I've been on HRT 5 years and I am trying to cut down. My consultant recommended the Evorel Conti but I've never tried it.

I am also terrified as I have been told I need a hysteroscopy. What was the pipelle biopsy like? Is it easier than a hysteroscopy?

A pipelle is the same process and they suck a tiny amount of cells from the wall.
I was very nervous I can't deny it not uncomfortable and it was a sharp pain but I believe the hysterectopy is worse but you can have a general anaesthetic which I want to avoid for reasons...

[KittyKats]

I am in the same position about the general as I have dysautonomia and they have said it might be difficult to keep my blood pressure stable. These tests are so worrying and so many women have to have them due to bleeding on HRT