Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Annemaria on June 29, 2016, 05:44:03 PM
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Hello,
I'm a 58 year old 7 yrs. post menopausal. I've been taking .6 premarin and 2.5 Medroxyprogesterone daily for 5 yrs. I decided to wean myself off slowly and starting taking the above every other day with no problems for a year and then went down to 1/2 dosage every other day for the past 7 months. Things were going fine until two weeks ago I had very sore breasts and nipples. It felt like I was going to have my period. Well, sure enough I started spotting 4 days later. Dr. sent me for an internal ultrasound and it showed my uterine lining at 8mm. I'm now waiting for an appointment for a biopsy. Needless to say I'm quite worried about this. Anyone here have had a similar situation?
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Sometimes the lining can build up on combi HRT because it is prepared at one dose but some women absorb it better than others so need a higher progestogen dose to keep the lining thin. Also sometimes if you are taking oral HRT and something happens to alter your digestion then your levels could fluctuate and if progesterone levels fall as a result, and the lining has built up a little - then some of it may be shed and you could get pre-menstrual symptoms as you experienced.
8 mm is not overly high although ideally it should be lower than this on continuous combined HRT. Mine was over 7 mm when it was last measured - although I am on cyclical HRT so this is expected as it builds and sheds.
The gynae is only doing his/her job by referring you and it's good to have this test hopefully to reassure you that all is OK. I had to have similar - hysteroscopy and biopsy (because of the thick lining and scan showed abnormality - which turned out to be small fibroid so OK). I had mine done in a city hopsital with no anaesthetic - just painkillers beforehand - and the gynae was brilliant. I had no pain at all. Some opt to have it done under GA.
Try not to worry and hopefully the biopsy appointment will come soon and will show that all is well.
Hurdity x
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Hi Hurdity,
Thank you for your reply. I appreciate it very much. My appointment is on Tuesday. I wish I could ease my mind, but the more I read on the internet, the more terrified I get.
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Hi Annemaria
Last October after being on Evorel Sequi for several years (HRT for 15 years, I am 63) and having a monthly bleed, with no complications I suddenly started spotting and also noticed an increase in vaginal discharge. I was straight on the Internet and liked you scared myself witless. I went to my GP who said the symptoms that were causing me to the think the worst were common with women on HRT.
My endometrial lining was 6.5mm I had a biopsy taken with a local cervical anaesthetic so not painful. Nothing was found.
I put myself through hell for nearly six weeks mainly because of what I read on the internet.
My next ultrasound the lining was down to about 2.5 and 4 months later it is back up to 6 even though the last 5 months I've been on continuous HRT. They have called me in again to discuss it and possibly offer another biopsy. This time I have the mind set as Hurdity says they are only doing their job and it is highly likely to be the HRT and I am determined not to worry ( although I am a very anxious person anyway). So Annemaria, please do not check the internet any more, in my experience it seems to gives the worst case scenario. Flutterby xx
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Hi Flutterby,
Yes, I have read more than I should have been. I have stopped and along with your words above, I'm feeling more calm now. Thank you for your reply Flutterby, it really did make a difference.
Annemaria
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Hi Annemaria
Hope everything went well today
Flutterby x
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Hi Flutterby,
Well my gyn is sending me in for a D&C with Hysteroscopy next Thursday. She said she didn't want to torture me any further as she couldn't get a sample. She did put everything in perspective about how this most likely came about with my dramatically cutting down on HRT which according to her caused an estrogen build/hormone surge hence the bleeding.
She was very comforting and assured me I'll be fine. I am feeling a bit lighter now. :)
Thank you for caring and your calming words.
Annemaria
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Hi Annemaria
Glad to hear you are feeling less worried.
When I had my biopsy done, although the gynaecologist was very good and gentle he also struggled to get samples and actually told me that I might have to go for a further procedure ( presumably D&C) if the histologist said there wasn't a sufficient sample as it was in the end there were enough cells.
Flutterby x
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Hi Annemaria, I recently had a D&C along with hysteroscopy and biopsies due to bleeding after being on conti hrt for some time. All my results came back clear ( my endometrial lining was 6.5mm) and the gynae said the same as Hurdity so I hope this reassures you further. :)
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Thank you Linz57 for your reply. It is comforting to hear others' experiences.
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Flutterby, wondering how your latest issues have been resolved. Yours are so very similar to mine.
Take care,
Annemaria
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Hi Annemaria
After almost a full week of no spotting I had 2 consecutive days of small bleeds. I don't feel very confident that the bleeding will stop with this HRT regime. I did plan to come of HRT in September but as it approaches I am having second thoughts.
I go to see the gynaecologist a week on Thursday.
Flutterby x
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Back from my d&c and hysteroscopy. Lining of my uterus was actually thin! She said not suspicious at all.
Procedure was a breeze mainly because I was in neverland. :)
Thank you all above for helping me through my anxiety.
Annemaria
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Pleased to hear everything ok. Flutterby x
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Wish you well also Flutterby.
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That's good news!
Must be something to do with cutting down HRT because a few years ago I cut patches in half to cut down as I was feeling so good and then same thing happened. Except for gp instead of recognising it as a possible period (which they decided it was) or hormone imbalance went straight for the worrying stuff! Thanks....!! Once the gynae saw scans he wasn't too worried but did the procedure just to be on the safe side, was fine as knocked out!
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Just been for the hysteroscopy and I have 2 uterine polyps one is 1.5cm and the other is about 2-3mm. The gynaecologist said they looked smooth and didn't think they would be "nasty", but was surprised he hadn't seen the larger one eight months ago. He provisionally booked me in for a D&C next Wednesday if not 2nd August. Couldn't get the pre assessment done today so hoping all results will be back on time.
Not going on Internet to read anything about polyps, apart from any posts of experiences on this site.
Managing to keep my anxiety reasonably under control and pleased I can have op so quick. Flutterby
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Annemaria - glad it was all OK :)
Flutterby - hope all goes well with your procedure - and try not to worry in the meantime!
Hurdity x
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Flutterby, your doctor wouldn't have said they were smooth and not nasty looking if he indeed saw something nasty.
Although, until it's all said and done, naturally we worry about it as I'm doing right now as well. I won't find out what my biopsy outcome is until Aug.2.
Thinking of you next Wednesday.
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Thanks Annemaria and Hurdity, just off to be swabbed etc at pre assessment check Flutterby x
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Had op today removed the large and small polyps and took biopsies, just need to wait for results now. He did say that he thought they were probably benign but obviously the histologist will have to confirm this. The consultant said he would leave the decision on whether to stay on HRT with me getting advice from Dr Currie. Flutterby x
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Music to our ears when you get the "looks like nothing ominous" when you wake up. I'm in the same situation whether I will be able to continue HRT. I'm certainly not excited about my withdrawal journey off hrt. :-\
Take care Flutter... :)
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Hi Flutter,
My results came back negative yesterday thank God! Strange twist in my story though... I just learned from my GYN that my lining wasn't thick to begin with, in fact, I had the spotting from lining atrophy. She said my lining was 1mm. I asked her how this happened and she said it was mismeasured during my ultrasound. She said she has seen this happen several times.
It's been a rough 6 weeks on account of a mismeasurement. Although at least I do know all is well down there.
Wishing you well also,
Annemaria
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Hi Annemaria
Great news. Bit concerning that mismeasurement can be a problem when ultrasounds are carried out. Hope you went out to celebrate, now you can put it all behind you.
Flutterby x
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Good news just had letter to say there were no abnormal cells in the polyp. :) :) Flutterby
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Hi Flutter,
My results came back negative yesterday thank God! Strange twist in my story though... I just learned from my GYN that my lining wasn't thick to begin with, in fact, I had the spotting from lining atrophy. She said my lining was 1mm. I asked her how this happened and she said it was mismeasured during my ultrasound. She said she has seen this happen several times.
It's been a rough 6 weeks on account of a mismeasurement. Although at least I do know all is well down there.
Wishing you well also,
Annemaria
This does sound very odd! Looking back at your original post you said you had been reducing HRT so it is a bit strange that bleeding from endometrial atrophy occurred after you had reduced your dose, and also that you felt pms symptoms - bleeding due to atrophy should cause no other obvious pms symptoms to my knowledge. However it's good that all is well :) - and that you can carry on with HRT if that's what you want to do?
Hurdity x
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Flutter,
Very happy to hear you received good news. Life goes on as before. :foryou:
Hurdity,
Yes, I have the same thoughts as well. She said there was less than 1mm measurement of the lining. The spotting I had over the weeks was not even enough to fill a quarter of a mini pad. I would assume I should have had a serious flow to expel the thick lining.
GYN said I could continue HRT, but I'm off them and wait and see what happens. ???
I'm going to bring up the period symptoms when I see her next.
Annemaria