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[Northerngirl]

Hi ladies, could really do with your advice on this as I can't believe I'm going down this road again.
Quick history,  2 years ago had investigations for pmb and blood in urine(eventually given all clear in February 2024)
I stopped hrt in December 2023
Started vagifem in March this year, everything great until last weekend when I had the tiniest bit of spotting.
I had a pelvic ultrasound and tvs in June  due to pain and check all was good after being diagnosed as having Hydrosalpinx 2 years ago.
Scan was totally normal, no hydrosalpinx anymore and lining back to normal limits.
So my question is should I be worried?
I've made a GP appointment but can't get in until the 29th with the GP who specialises in women's health/HRT.
The thought of going through the hysteroscopy/biopsy journey again is filling with me dread all over again as this will be the 3rd time.
Sorry to waffle ladies....I'd appreciate any advice...Thanks

[CLKD]

I don't think that is any need to worry unless it's every day without wiping or a lot of blood.

How often are U inserting VA treatment, it mayB that if your oestrogen levels have dropped, tissues internally may dry = a 'show'. 

U waffle.  I suggest U up the VA treatment to every night for 2 weeks which should ease symptoms.

[CLKD]

And don't keep poking ;-)

[Northerngirl]

Thanks CLKD,
I use vagifem twice a week and dr woolff vaginal moisturiser or Yes the other days.
To be honest the Vagifem has eased the uti symptoms so far, so I thought everything was going well with it 🤷‍♀️
It was the tiniest bit of spotting, just one morning.

[CLKD]

That's fine.  As oestrogen levels drop the body may continue to become dry including the vaginal area.   Up that Vagifem to every night!  U should notice benefit within a couple of days. It can be used every night for as long as is necessary, we cannot overdose on oestrogen ;-).  When my symptoms niggle I swallow a couple of 'nurofen' to ease the nip as the urine flow shuts off.

[Northerngirl]

Thanks again, should I be worried about the spotting though? Obviously don't know what caused it 🙄

[bombsh3ll]

With recent negative investigations and known vaginal atrophy, I personally wouldn't rush to the GP with a bit of spotting.

I would simply increase the vaginal estrogen, using it daily if necessary, and adopt a watch and wait approach.

If it is persistent, doesn't respond to improved estrogenisation of the local tissues or becomes heavier or associated with symptoms such as pain or offensive discharge, then I would see your GP.

I am also assuming your cervical screening is up to date.

Gynaecological cancers that present with bleeding typically develop and progress over years, not days or weeks, and I personally believe the sense of panic and urgency with which every little bit of spotting ends up being referred as "urgent suspected cancer" does a lot of harm.

[Northerngirl]

Thanks Bombsh3ll I appreciate your advice.
Yes my last cervical screening was in April.
Ultrasound/tvs in June and hysteroscopy/biopsy January 2024.
Strange thing is I felt the VA was a lot more comfortable these days thankfully and would never have thought it could be that. However I'm still learning with this and only 6 months on vagifem.

[CLKD]

Hormones drop which may cause the body to become drier.

[Northerngirl]

Ladies, following on from my above question I'm just wondering if any of you have ever gone to the GP with one off episode of spotting and not been referred for further investigations?
My appointment with GP is Wednesday and I'm really confused....do I go or not?
I feel with all the recent scans etc that I've not got anything to worry about but I'd never forgive myself if something was wrong and I'd ignored it.
I really think it is VA related so could do with something other or aswell as the vagifem as it's obviously not enough to use the vagifem on it's own.
If I go to GP I've obviously got to tell her the full story and I know she'll go straight to 2week referral...they always do to cover themselves.
I'm really confused and annoyed at being in this situation again 😕

[CLKD]

What is your gut feeling?  Watch and wait if symptoms aren't troublesome?  If U cancel the appt some1 else can take it, that depends on how worried U R.

Some require over all HRT as well as localised VA treatment: how often are U applying it and have U tried an extra dose mid-morning a few times in the week 2 C whether it helps. It can be a bit Trial and Error as hormones fluctuate. 

Personally if symptoms weren't bothersome I would postpone the GP appt.. 

[bombsh3ll]

You could just say you aren't finding your current treatment adequate for the VA and can you please have both pessaries and cream to use as often as needed.

I personally wouldn't mention a one off episode of spotting in this context with recent negative investigations and no risk factors.

If there really was endometrial cancer, it would continue to bleed, it doesn't play peek-a-boo & is not just a miss one bit of spotting and you've sentenced yourself to death situation!

[sheila99]

When I had precancerous cells the spotting was bright red and quite big drops. If yours is pink and only a little I think it's far more likely to be va than anything serious (though obviously this is just my experience, I'm not a doctor).

[Northerngirl]

Thank you ladies, really appreciate your advice as always.
My gut feeling is that it's probably nothing serious as I've had so many investigations over the last 2 years,the most recent being in the summer and everything was fine.
The symptoms definitely aren't bothersome....it was a tiny bit blood on wiping over 2 weeks ago and nothing since but if it's down to VA would  I not be spotting all the time due to the dryness?
Can Vagifem cause spotting?

I always worry that if I up the treatment it will cause more bleeding rather than help.....silly I know!!!

I try to get away with using the minimum amount of hrt ,this was the same when I was on systemic. I definitely wish I didn't have to use anything but I suppose we all do.
It's just an ongoing minefield that us ladies are trying to navigate through isn't it.  I thought getting older would be easier than this and I'm only 57....what joy to look forward to.

[CLKD]

Whilst VA treatment is unlikely to cause spotting, very thin vaginal walls may well bleed on contact.  Use every night for a week, getting the skin supple eases thinness which should improve symptoms over all.