Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Cal67 on July 23, 2022, 08:31:55 AM
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Hi I'm after some advice please. After a phone call from my doctor a day after my ultrasound to say she is fast tracking me for a biopsy within two weeks. I'm obviously very scared something sinister was picked up. My HRT story is I was on Evorel sequi and having regular periods but my symptoms started to come back. So the doctor put me on Evorel conti as she said it would be fine as I was turning 54. For the last few months I have been bleeding lightly so went to the doctors and she sent me for the ultrasound. She never said if I should stop using the patches and I was too shocked yesterday to ask. Has anyone else been through this and did they stop hrt?
Sorry for the rambling I'm still in shock :'(
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Of course it's a shock because mayB the Doctors know more than they think to let the patient know! Fast tracking is usual if there is a thicker than necessary womb lining. Did she say how thick it might be?
How have your periods been in the last couple of years for example, prior to HRT? Some find that keeping a mood/food/symptom dairy of use (diary) to chart progress. Continue with the HRT until someone comes along on here. Was the regime helping the symptoms that you wanted to ease?
Try not to panic. A few days either way won't make a huge difference to any outcome.
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Hi bleeding is normal for up to 6 months when you switch to a Conti regime x
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Make notes of what you need to discuss either with the GP/Nurse Practitioner at your surgery or with the Ultrasound Dept..
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I think you're another victim of the 'everyone is meno by 54' culture. You're having regular periods but they put you on a conti regime - it would be more surprising if you DIDN'T bleed. As your symptoms returned you need a higher dose of oestrogen not a conti regime which is the same dose. Evorel sequi and conti only come in one strngth so you may have to change hrt. Most likely the scan showed a thickened lining as you haven't been shedding properly due to the conti regime.
I have been a victim of it too recently. As above, it seems it always goes on the 2 week pathway and there seems to me to be unnecessary panic about it. You can ask for a phone appointment first (I did) to give you an opportunity to ask questions. The person doing the scan refused to give me any information at all, my gp told me thickened lining, 2.5mm too thick (though after 8 weeks with no bleed on sequi imo surprisingly thin and nowhere near dangerous). It seems 'unexpected bleeding' had been added too. This was because I told them I had 3 of my own periods last year - which, as all medics know, is completely impossible as I was over 54. They even told me if I was 10 years younger at the same stage of meno (probably had my last bleed but not 1 year yet) they wouldn't have done anything. My biopsy came back clear, I'm sure yours will too.
Perhaps you could ask your gp how she thinks a conti regime on the same oestrogen dose is going to prevent symptoms of oestrogen deficiency? And why she isn't increasing you oestrogen which will aleve the symptoms?
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Cal it probably just means that the ultrasound showed your uterine lining was a bit thicker than it's supposed to be. This is usually not a cause for concern, it usually just means you need more progesterone or a change in progesterone - but they have to check, to be sure it's nothing else.
Don't stop your HRT - get the biopsy done and find out what it is. Then you might need to adjust what you are taking.
By the way, the biopsy can sometimes be very uncomfortable if not painful, so do some research on this forum and elsewhere about that. You can take some ibuprofen beforehand and also request a local anaesthetic in the cervix which some find helps. You can ask them to stop at any time. You should be given options and should never feel forced to go through great pain, so let them know if it is hurting. I don't want to worry you saying this, but sometimes doing some prep helps people feel more in control of the situation.
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Thank you all so much for your replies. The doctor did say it showed a thickening of the womb lining but not how thick. She did say something about cancer, but to be honest the conversation was short and I didn't take it all in.
I was getting monthly periods on the Sequi ,so was surprised when I was put on the Conti patches. But thought the doctor knows best.
I just want the test done and results over with ASAP. I didn't sleep a wink last night when the doctor rang. :'(
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Try not to worry. 95% of the time, especially when women are on HRT, it's nothing at all and just a thickened lining.
I actually wonder what is going to happen because this tends to happen more when women are on HRT, so we have more and more women getting referred for biopsies and the health service isn't exactly coping brilliantly at the moment. Given the vast number of women starting HRT recently, they are either going to need to come up with revised protocols and change the NICE guidelines for biopsies or train up and have a heck of a lot more doctors to provide them.
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Sorry not sure how to reply to individual replies. I have been on the Evorel conti since November 21 x
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Don't worry about replying individually, keep us up to date with what happens on here ;-)
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You can ask your gp surgery how thick it is. You're at greater risk of cancer if it's thickened but it's unlikely it was thick while you were on sequi. They consider anything over 4mm too thick (either just after a bleed or post meno on a conti regime), if they took it just before a bleed it could have been 16mm without worry. I found the biopsy painful but not excruciating. I didn't take pain killers and my uterus is tipped back which probably made it worse. Take a pad with you as may have some bleeding afterwards. And don't worry, I don't think you're at high risk at all. It's probably more a belt and braces approach.
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Thanks everyone. It really does help to talk. I will let you know how it goes. Hopefully I'm worrying over nothing 🙏
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So my endometrium biopsy is tomorrow afternoon, and to say I'm nervous is an understatement. Does anyone have any tips to make it go a little easier please 🙏
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What U most nervous about?
:bighug:
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Good luck. My main tip would be to tell them you are nervous and to ask the nurse to hold your hand. Also, focus on your breathing... in for 4, out for 6....
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Take a heavy duty painkiller beforehand if you feel you need it. They are very used to apprehensive women and will do their best to reassure you. It's easier for them if you're relaxed, try to focus on relaxing 'down there' as you breathe out. You'll be fine.
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If you find it really difficult you can stop and they will do it under general. I've had one under GA for lining at 16mm. Nothing sinister - simple hyperplasia no atypia though they aren't sure why! Of course at 53 I shouldn't be having periods 🙄 Hope it goes OK x
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I had my biopsy done yesterday and yes it was painful but thankfully quick. The doctor said the ultrasound i had previously had shown over 20mm in parts and 6mm in the rest. It also shown a small lump. She didn't seem overly worried about that, but she might have been trying to reassure me. Now it's just the worry of waiting for the results. :(
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A small lump could be anything and nowt. It's the way these professionals throw 'X, Y, Z' without being explicit, really annoying. Any idea how long U will need to wait, do the results go to your GP or directly to you?
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They said two to three weeks for the results and the hospital will call me.
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Well done on going :medal:
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It could just be a little fibroid in the lining, which is very common and wouldn't require any treatment...
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Well after a long and worrying wait I've had my biopsy results back. And thankfully I've had the all clear. Seems the thickening was due to the hrt. I've been advised to get a mirena coil fitted along with using gel.
Has anyone else used this combination?
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:ola:
Not used it myself but many do, it's particularly good for sorting out this type of problem.
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OFten they fit the Mirena when the do the biopsy. But if you search the forum there are loads of posts about Mirenas...
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Hi Cal that's brilliant news.
I had a hysteroscopy done on 8th July & had a fibroid removed. They said it would take 4-6 weeks for the results to come back from histology/pathology whatever one it is. After 5 weeks I telephoned to chase & was told not back yet, I telephoned yesterday & was told they have just come back but the consultant is away on holiday till Monday :( & apparently no one else can read them so it will be over 6 weeks!
This is my 2nd hysteroscopy in 18 months.
The 1st time the gynae suggested fitting a Mirena coil but I declined as I was quite happy on my HRT (Femoston Conti Low dose) taking 1/2 tablet a day even though she said it was probably that it was causing growths.
This 2nd time they suggested it again & I declined again.
I think it is worth considering as the progesterone part of your HRT. I did have this combination when I was in my late 40's & started the menopause & it worked very well for me.
May I ask if you had your procedure done privately or on the NHS?
Cazikins x