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[Catlover67]

Posted recently to say that I'm 58 and still haven't gone through the menopause. I have a long history of fibroids that have caused years of flooding, bleeding between periods & spotting. This year the periods have eased right off, become lighter with long gaps (not had a proper one since April) but been light spotting since July. GP worried this could be post meno bleeding as my fsh very high & put me on cancer pathway. All fine but no real explanation for the spotting although suggested likely the fibroids pressing on the lining. The fibroids have shrunk a bit since my last scan a year ago so have avoided HRT as I don't want them growing again. However, as I am suffering from menopause symptoms as well as the spotting being a nuisance I caved in and asked GP for HRT.

GP worried the HRT could make the spotting worse so referred back to gynae for advice. They've come back and suggested cyclical hrt.

I'm no expert but I know cyclical will give me a regular monthly bleed, that I absolutely do not want. I also understand Nice guidelines state women over 55 can have continuous even if not post meno.

Am at a loss.....

[CLKD]

U could have kept on the other thread so that it's easier to keep up   

Why didn't your GP refer U to a dedicated menopause Clinic?

[Catlover67]

Because I've found that people often don't read the updates and reply to the original post. Is there such a thing as a menopause clinic without going private?

[Mary G]

Catlover, I'm surprised they didn't suggest a Mirena coil to avoid the excessive bleeding and to shrink the fibroids.  There's no reason why you should put up with bleeds on a cyclical regime.

Can you afford to seek help from a private menopause specialist?  I think it would be the best option for you.  If not, you should push your GP for a continuous combined HRT regime.

CLKD, the NHS have ridiculously long waiting lists for menopause clinics which can be over a year.  Most women can't wait that long.

[Catlover67]

Catlover, I'm surprised they didn't suggest a Mirena coil to avoid the excessive bleeding and to shrink the fibroids.  There's no reason why you should put up with bleeds on a cyclical regime.

Can you afford to seek help from a private menopause specialist?  I think it would be the best option for you.  If not, you should push your GP for a continuous combined HRT regime.

CLKD, the NHS have ridiculously long waiting lists for menopause clinics which can be over a year.  Most women can't wait that long.

They did suggest a Mirena but I had one in the past which caused constant spotting as well as acne so not an option unfortunately. I do have private insurance so may explore a private meno specialist as I did suspect a massive wait on nhs as you say, not that the GP even suggested it. I am surprised cyclical was suggested, I absolutely do not want to go back to regular bleeds, especially as I'm clearly so close to full menopause, if not there already according to my bloods. How will I know if I've reached full menopause if I go on that? Also just realised I've not spotted for nearly 3 weeks, hope I'm not speaking too soon!

[CLKD]

There are waiting lists in the private sector too which is why getting onto a list sooner rather than later is important.  Some patients in any speciality also put themselves forwards to be called at short notice if there is a cancellation.  Most women sadly have to wait as do patients with other conditions unless they can afford to pay or have an Insurance Scheme.

I get your point Catlover67 however, if you continue in your 1st thread it will bump it so people can reply.  Or there is the option to change the heading ....... so that members can keep up2date without the need to read back.


Women R not 'close' to menopause until we have not had a bleed for 12-14 months without using HRT.  My periods waxed and waned for a few years B4 stopping.

[bombsh3ll]

It's your body, your choice.

I agree there is a strong case for continuous progestogen treatment, and I would opt for a synthetic progestin above micronised progesterone.

I would simply tell your GP what you have said above.

You could also say that you are no longer bleeding now, even if that's a white lie.

Also, if you get separate estrogen and progestogen, the dose of progestogen if taken cyclically is generally twice that you would use if taken continuously.

So depending on the preparation you have, you can just take half the dose of progestogen daily rather than the full dose for half the time. The overall amount taken over 28 days is the same.

This is nice because gives women themselves agency over whether to use it cyclically or continuous if they have a really rigid provider.

[Catlover67]

Well I spoke too soon. Just started spotting again. Every time I get hopeful I won't bleed again, it happens! Longest time I've ever gone is 10 weeks (twice this year). So so sick of this. Spoke to my husband (who's sick of it too) and agreed we can use the private insurance to get this sorted once for all and if that means hysterectomy, so be it. At least that will ensure I never bleed again. 12 years of dysfunctional bleeding and 3 lots if surgery to remove fibroids has taken its toll.  Not sure who to ask my GP to refer me to, will have to see what she suggests, but wondering if the gynae who did 2 of my 3 surgeries would be a good start.

[Mary G]

Catlover, I'm glad you are going to get help privately.  Sometimes a hysterectomy is the only option for problematic fibroids and then you are free to use oestrogen only HRT.

You definitely need some proper help quickly so I hope you can get an appointment with a menopause specialist soon.  From what you have said, it sounds like a Mirena coil is not a good option for you. The specialist might suggest you try oral synthetic progesterone before going for a hysterectomy and you might find you get on well with it and stop bleeding but with fibroids there are no guarantees.

CLKD, people do sometimes have to wait a while for private appointments with a menopause specialist but it's nowhere near a year so there's no comparison.  Most women on here work and are trying to hold a job down so they can't sit around waiting indefinitely for an NHS appointment.

[bombsh3ll]

If you want a hysterectomy you would be best off emphasizing pressure symptoms rather than bleeding as the latter can generally be controlled medically in the vast majority.

It is not clear if any systemic progestin or estroprogestin combination has ever even been tried here, nor whether vaginal atrophy has been excluded which is a frequent cause of spotting in this age group.