Menopause Matters Forum
General Discussion => New Members => Topic started by: AndieKC on June 12, 2018, 11:32:54 PM
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Hello everyone,
I was wondering if anyone has had a similar experience: menopause hit like a tornado at 44. I struggled on my own for 2 years with very severe hot flushes, nights were even worse, no deep sleep, terrible palpitations I had no control over, shivers following each hot flush, I nearly had a breakdown. Reluctantly, aged 46 I started Elleste Duet 1mg sequential (Estrogen + progesterone) and it was like magic - stopped hot flushes in 3 days, never returned, sleep sorted, lost weight, it simply gave me my life back. Now the docs are forcing me to stop it, and have Mirena.
This is due to erratic bleeds that continued past the acceptable first 6 months. TVUltrasound showed 6mm endometrium, but biopsy showed only simple hyperplasia without atypia.
Hospital consultant is recommending (more like forcing me) into Mirena, but I'm scared of that, and also advised to stop HRT completely. I have 1 month worth of Elleste left to wean myself off it (not long enough) but doctors don't seem to understand how badly I coped with the hot flushes and lack of sleep. If I go off the pills in such a short time, surely the flushes and lack of sleep will return with a vengeance.
I'ce read that upping the progestins or changing the delivery method is the usual course of action, not such a drastic stopping of the magic pills plus the Mirena. Ir maybe these body identical hormones? I don't want to give myself cancer but i need to be able to function (I'm self employed). Any ideas?
Thank you
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:welcomemm: AndieKC
Oh poor you it is so annoying when docs etc do not listed properly to what their patient is saying. I can't advice too much as I'm not that knowledgeable but firstly I wanted to welcome you & secondly I just wanted to let you know that I have had several mirena coils fitted & for me they were the best thing I used in my HRT medication so maybe have a re-think about having one.
Just one more thing - maybe go back to your GP & tell them your concerns. Not all GP's agree with hospital consultants if it is causing stress to their patient, you may be able to come up with a more suitable suggestion.
I wish you well with whatever you decide.
Hopefully some other ladies will be along soon to offer more help & advice.
Cazikins
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The Mirena is great for many women - don't feel frightened - give it a try. I had t with separate oestrogen for 4 years adn ti was the best HRT combo I every tried - and I have tried everything going. Dg x
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Thank you so much for replying and for your support, I will be seeing a GP this Friday so I'm preparing for the appointment. Thank you also for your reassurance about Mirena Coil, can I ask a stupid question - once the coil is fitted, will I know/feel it's there? (Hope not...).
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There can be some tummy cramps at first after fitting but this should settle quickly but you will completely forget you have it after a very short while. Either oestrogen pills, Oestrogel or an oestrogen patch is all you need alongside the Mirena and you may find after a time you won't get any bleeding at all.
The Mirena with separate oestrogen is a very popular hrt combo. DG x
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Hi
Thank you for such a quick reply again, I really appreciate it. Interestingly, in the meantime I have received a reply from Dr Heather Currie who also recommended the Mirena + oestrogen patches combination, I just hope I'll be able to convince this new GP to prescribe it against the recommendation of the hospital consultant who is categorically refusing any oestrogen at all. Dr Currie sounded confident that the bleeding is caused by hyperplasia caused by sequential HRT when the continuous HRT would be a better choice. I am planning to print out Dr. Currie's email and take it to the GP on Friday, let's hope it works!
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Dr Currie is a menopause specialist and the hospital gynae was clearly not up to speed on treating menopause.
I would definitely print off the recommendations from Dr Currie and your GP could always email this to the hospital gynae who should ok it - I'd be surprised if the hospital gynae went against these recommendations. DG x
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Thank you Dancinggirl,
I am now at peace with having Mirena Coil, the appointment will be in 2 months time to have it fitted, now I just really really hope the Gp will prescribe me something in the meantime. I have started ‘rationing' the Elleste pills I've got left and it's not good, hot flushes and cold shivers came back within 3 days, palpitations all night, it's relentless. Can't function at all, can't imagine 2 months without anything, so hope the doctor will play ball on Friday
Sorry I'm ranting here, am feeling so helpless with everything
Thank you for your support xx
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Really pleased to hear you are going through with having the Mirena, I'm sure it will help you. Shame you have to wait 2 months though ???.
Surely your GP must consider something to help you till then.
Let us know how you get on.
Cazikins
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Hi Cazikins
Actually I've found out Mirena can be fitted at my GP in the next two weeks, so I'll go for that, but we still have to convince the hospital consultant to agree to estrogen, even though I took Dr Currie's recommendation with he to the GP who is menopause & hrt trained. The GP sides with Dr Currie but still claims to not be able to prescribe estrogen unless the hospital consultant agrees! It's the same hospital consultant who admitted she didn't know enough about HRT... I've asked Dr Currie to intervene, am losing my will here, so frustrating! Dr Currie clearly explained that the hospital consultant is wrong so I really hope we will get somewhere soon,
Thank you so much for support, and listening to my whinge!
Xx
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Hi AndieKC
Thats great that you can have it inserted at your GP.
I can't understand why your consultant is being so awkward. Maybe your GP can contact her & put a bit of pressure on, or at least give an explanation as to why it can't be prescribed.
Anyway good luck & let us know how it all goes, oh & by the way you are not whinging. ;)
Cazi x
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Hi Cazi
Thank you for your encouraging words,
Dr Currie has now written both to the GP and the hospital consultant, and I have an appointment booked with theGP on Monday, really hoping to get a prescription for continuous combined HRT that Dr Currie recommended while I'm waiting for the Mirena.
As for the hospital consultant's strict ‘no-estrogen' policy, apparently their guidelines tell them to remove the cause first, in this case making oestrogen the culprit. The truth is that I was nearly two years postmenopausal when I started HRT so ideally I should have been put on continuous combined, but because I was only 45, the original doctor back then started me on sequential (Elleste Duet), so the problem really is not enough progestin against the estrogen.
I get it that neither the GP or the consultant want me to get cancer, but now we have a farcical situation where the problem (simple hyperplasia and erratic bleeds) are caused by the wrong meds but while the merry dance is going on (ultrasound, biopsy, appointments with GP etc), no one seemed to see the obvious - that I need to be on the continuous combined, with higher dose and everyday progestin.
Really hoping that Dr Currie's intervention will finally get me there - it's all been going on for months, it's so incredibly frustrating.
I cannot wait to have this over and done with, and move on with my life. Hopefully it will all be worth it in the end!
Andie xx
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That's great news that Dr Currie has intervened for you AndieKC I think that's something that we've all hoped to see posted here, I often wonder if ladies who pay the fee to email Dr Currie and get help or advice then don't post it here because it's been resolved.
This would be a great shame because we all kind of have that hope deep down that it's not simply a platform here and that yes she's provided a great resource in the forum but also it would be great to know that she's also available to point us in the direction of where to get help when we have such huge barriers and resistance to overcome and we are maybe feeling a bit intimidated by the system.
I for one made use of the email consultation service and was met with a very hostile reaction from my then gp,who is this woman scenario,and even since changing gps practices on dr curries advice I still have had huge issues.
It's all very well saying print off guidelines and print off info to present to your gp but they blatantly refuse to even read or acknowledge the presence of that bit of paper and go on the attack and when you don't feel well or are weepy nothing you can do or say will influence the arrogant swines oh and by the way your ten minutes are up next patient please.
Well done for standing your corner and I hope it all resolves for you it's not fair to leave you suffering while they fanny around with their theories and tests so keep battling your doing great xx
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Hi Daisydot
Thank you so much for your post, you literally described my experience in the past. The doctor tapped his watch, times up and all that.
Dr Currie had been fantastic support, I took the printed out emails, together with her book and printed out research papers and left it all with this new GP, but still haven't heard back. I'm losing hope, feeling so miserable, can't think of anything else but how will I cope if they don't prescribe me anything. I really expected the last GP appointment be more a discussion about which of the recommended options I want, instead it was no result, she needs to consult the hospital consultant etc. As if Dr Curries emails were not even there... If Monday doesn't get me a prescription I don't know what I'll do
Do you have any experience with private GPs? I could get an appointment at a Nuffield Gp but it is £100 and they are not menopause specialist and I'm not sure how much investigations/blood tests etc they would want to do.
I feel like I'm banging my head against the wall.
Also the private menopause Gp specialists around the country they all have 2-4 months waiting lists. And of course it costs hindered of £££...
I have tried eating soya, sprouting seeds, beans, the whole works, nothing can fool the hypothalamus when estrogen is not there...
Any ideas welcome, I'm going crazy here ...
Thank you
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Hi AndieKC.
yes we've all been there with gps some more than others that's why I always say If you get a good one treasure them they are very few and far between.
I wouldn't go to the private gp at Nuffield your just wasting your money.
I personally go to Mr Tony Parsons he's a private meno expert with credentials you could paper the walls with but more importantly to me he's brimming over with compassion and such a lovely approachable man,it's like chatting to your dad.
He's based in Coventry Nuffield hospital it's a lovely place have a google and read up before you opt for anyone but I highly recommend him.He also works for the nhs as a consultant and divides his time between that and private.He can see you pretty quickly usually tuesdays and Thursdays clinics at Coventry.He won't pressure you in any way for tests and he will in fact write a report to your gp to try and get them on the nhs for you,I had my dxa scan done on the nhs because of falls and my risk of fracture thanks to him.the most important thing is he'll listen to you and work with you and your gp to get a resolution for you.Ive been with him a while now and we've battled like hell with his support to get me in a good place and I'm so grateful to him my gps at first defied his recommendations but I went in all guns blazing and wrote to practice manager implying I'd go further because they were undermining my consultants expertise and he backed me with letters directly to the gps.Phone Nuffield at Coventry and get the costs and waiting times for appointment you'll be pleasantly surprised.you can then keep it under your hat until you get Monday over with then you may not need him but at least it's a light at the end of the tunnel for you isn't it.xx good luck.
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Hi Daisydot
Just found out that nearest appointment with Dr parsons at Nuffield Coventry is end of August and it's £195... if I could get that long without HRT then I wouldn't need it at all. May I ask is there a reason/ did you have a negative experience with Nuffield GP services? I have booked an appointment for next Tuesday in case Monday appointment with nhs GP fails. I can cancel without charge if I don't need it, is a complete waste?
Andie xx
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Hi AndieKC wow I must stop recommending him he's getting too popular lol.
The only reason I wouldn't go to Nuffield gp is you need a meno specialist not a gp and he/she would most likely not over rule your gp and gynies advice it's a very tricky situation I would think best case scenario is she'd refer you,well I'd hope that's what she'd do as their ethics are bound to come into it.
She will not have the expertise that a meno consultant would have.
I would instead book Mr Parsons or similar,your choice,for next available appointment because if your gp doesent play ball on Monday you're nowhere anyway and if she does then you can cancel with meno consultant,it's up to you but that would be my advice.good luck with your descision xx
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Hi Daisydot
You're absolutely right, that's going to be my only choice if Monday doesn't work out.
Thank you so much xx
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Hi AndieKC try and get oestrogel on Monday to use with the mirena as apparently this is a good combination and if no luck with gp there are online pharmacies in London that you can use and pay for it.usyal procedure is you'll have a consultation with a gp online then he'll say yes or no he can prescribe hrt,you being on hrt already shouldn't be an issue but you have to jump through their hoops,it's around £30 for the consultation and £30 for the oestrogel if I remember right and I think you can buy 3 cans for £69 they're pretty quick with delivery normally next day.Its just an option for you if you've no success on Monday but fingers crossed.xx
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Hi Daisydot
Thank you for the recommendation, may I have the name of the London online pharmacy you mentioned?
Thank you so much xx
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I've given you it under your other post on forum guide andie check it out.x
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Hi AndieKC
Not sure if I've answered any of your posts but agree with the others that you should not have to go privately or buy oestrogen online due to the error by your hospital consultant.
So pleased also that Dr C has been supportive and if you don't mind please could you let us know how you went about Dr C intervening and writing to your GP and consultant? I presume you paid for your original question - and then what? Did you pay for further questions and did you ask Dr C to write to the medics and did you have to pay further for this? I ask because this process may be very helpful to other women, as I understood the e-mailed advice was just that - albeit a fantastic way of getting a specialist consultation/advice for almost no cost, which should be sufficient for most GPs!
Glad to hear you have read up on it and printed the info for your GP - the very best of luck ( and determination) at your appointment tomorrow. You sounds like a woman who is able to stand her ground and you will need to do that tomorrow. If there is no other medical reason why you should not have oestrogen - and you are suffering from menpausal symptoms, then it is your right. As you have discovered simple endometrial hyperplasia without atypia is not a contra-indication for oestrogen!
All the best :)
Hurdity x
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Hi Hurdity
I have great news to share, the Gp finally prescribed me Continuous Combined hrt - Kliovance plus Noriday as recommended by Dr C. This is because Kliovance has the same types of hormones as Elleste Duet which I thrives on, but because Kliovance has a lower progestin than Elleste, and I have simple hyperplasia, noriday adds additional progestin of the same type, to stop the endometrium thickening further. This is progestin therapy until I have the Mirena fitted- appointment in August , and I'll go on estrogen patches then.
As for Dr C, yes, I did email her originally through the website after paying the fee a couple of types. I owe Dr C a huge thanks for her involvement. I dont know if this was an exception but I am extremely grateful - perhaps Dr C felt equally frustrated with the mistaken beliefs on which the consultant's recommendations were based, and the other consultant's statement that “in this country we do not prescribe continuous combined hrt†was so incredibly wrong that perhaps Dr Currie felt it needed addressing.
I also spent the last three months or so researching everything about menopause and hrt - literally, it's been like doing a masters degree in hrt! A week ago I went to the Gp with 4 research papers printed out, and today I had another 4 for her to support my case - everything from Royal Colege of ObGyn to trials on HRT, endometrial hyperplasia etc. I have even had a book written by Dr Currie, read it, underlined all passages relevant to my case and left if all with the GP.
To sum it up, because I was nearly 2 years post menopause when I started on Elleste Duet, they could/should have really put me on Continuous Hrt. But because I was only 46, the original doc thought sequential HRT was okay. However, when the bleeding didn't fall into a regular pattern after the initial 6 months, the signs were that more progestin was needed, and I started my research and started realising that continuous combined hrt was needed. So I started asking for it, but it was as if I was asking to be prescribes a banned substance!
As the combination of erratic bleeds and hyperplasia is taken very seriously, the doc sent me for ultrasound which showed 6mm endometrium but it was measured at the wrong time anyway, towards the end of the oestrogen only pills. It should be measured after the monthly bleed when the lining has been shed but never mind. I was sent for biopsy which showed simple hyperplasia without atypia. That's when the whole circus started, with the consultant recommending stopping hrt, only have Mirena, no estrogen and the GP wouldn't go against.
The initial two emails from Dr C that I printed out and took to Gp didn't get me the prescription but at least the GP started making calls to the hospital consultant etc. Then Dr C wrote a strongly worded letter - both to the hospital consultant and the GP, and I received a copy this morning - what a read that is! And that finally got the Gp to prescribe the continuous combined with extra progestin for now, and reassuring both the GP and the consultant that there's is no need to stop estrogen (as I am on a low dose 1mg tablet) as long as there is enough progestin.
So I'll have the Mirena fitted either during the biopsy scheduled on 14th August at the hospital or sooner at the GP surgery, and then hopefully the hyperplasia will be reversed.
Anyone going through a similar battle, I recommend learn everything there is to know about the problem, read all the research, NICE guidelines, GP guidelines, RCOG advice etc, print out a copy for doctors, and keep a note of all names, dates and everything the docs say. It is shocking how much misinformation and lack of knowledge it out there among GPs and consultants, Dr C said she was ‘sadly not surprised'. I must say it was like a court case and Dr C being the best lawyer in the world. It is not easy to prove a doctor wrong, but it's my body my health and look what happened when I blindly trusted doctors with the Sequential HRT. I also had to often remind myself that I didn't do anything wrong, this was not a lawsuit where I was the defendant, but boy did it feel like that sometimes!
Does this answer all your questions?
Thank you so much for helping me stay sane!
Andie xx
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Hi Andie
I'm so glad to hear that you got sorted with your hrt. Well done for battling. Like you, I also feel like I've studied for a degree in HRT! Good luck with the new regime x
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Brilliantly done AndieKc!
You shouldn't have had to have this battle with the medical profession but I'm so pleased your persistence paid off. Hopefully your experiences will ensure menopausal ladies visiting your gp in the future will receive appropriate treatment.
You've made my day Andie 😀👍🏻
Robin
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Bravo Andre - a women after my own heart. I always go to doctors appointments with everthing written or printed out - I can tell the doctors hate this as it forces them to address the problems and put these things on record as well.
We do need to be educated better about our bodies and how it works. If women were told what to expect when menopause hits, we would be better prepared and know what to ask for. DG x
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Andy - thank you so much for your post. It is useful for people like me - I have a surgery with 2 disinterested doctors and the prescribing nurse takes all the responsibility and she has her own interpretations and cannot remember which preparations are continuous or sequential so I don't have a great deal of faith.
You have to strike it lucky with a locum, so it is a bit like Russian roulette.
I read and learn :)
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Sorry I missed this as v busy lately. Thanks for all that detailed info!
ABSOLUTELY FANTASTIC NEWS AndieKC! You have done a brilliant job and I know the feeling. I did the same myself (reading, research, writing to Dr C on one occasion) - although I was lucky to have a gynae specialist GP at my local practice, but still I have been to ordinary GPs who are really are so ignorant and have threatened to stop my HRT for various reasons - I won't go into it now.
You are an example to us all - and hope that members of this forum have helped you in some way. Even if you already know what to do sometimes it helps to have encouragement that you are doing the right thing - with other women giving you support or be a sounding board for ideas (or for sounding off!)!
I find it unbelievable the fact that docs do not take into account the stage in your cycle when deciding to refer for thickened endometrium. Of course it would have been thicker at the end of the oestrogen only phase - I posted elsewhere today that mine measured more than that (7.4 mm) about 5 days after my bleed stopped and I had several more weeks of oestrogen only to go! However in your case - it is always good to be investigated (womb lining etc) to check all is well - but not if it means erroneous decisions are made!
And bravo also to Dr Currie - for stepping in - that is amazing!
Well - all the best to you and your womb lining - do drop by to tell us how it goes re the bleeds etc - and sounds like you're now in a great position to advise others - if you felt so inclined but quite understand if you now want to put it behind you and get on with making the most out of your life :)
Hurdity x
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Hi Hurdity and dahliagirl
Thank you for your replies, I've been finding the forum a huge help, kept me sane.
Of course I'd be happy to help others, happy to share what I've learnt, just let me know how...
P.s. got a surprise appointment from the newly set up hospital clinic specialist for these things like Mirena so I'm having it fitted on Monday.
Any tips on what painkillers are best to take? Apparently ibuprofen is good for the pain after and paracetamol for the pain during, so take one of each?
And as for estrogen, patches or gel or tablets to go with Mirena? I did really well on Elleste Duet 1mg except for the hyperplasia...
Thank you all ladies,
Not planning to disappear from the forum xx
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Good luck for tomorrow AndieKC, you'll be fine.
Take 2 paracetamol before hand - don't take 1 of each..
"If you need further pain relief after the procedure then take 400mg Ibuprofen every 8 hrs (max 1200mg in 24 hrs).
AND/OR:
Paracetamol 2X500mg every 6 hrs (max 8 tabs in 24 hrs)."
The above dose has been advised for my hysteroscopy I am due to have next month, I am assuming it would be ok for your mirena fitting
Cazi x.
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Hi AndieKC
Sorry - have only just seen this - have been busy over weekend - hope it went well today and you asked for the regime you wanted - do let us know how it went? I would have recommended patches because I get on so well with them but others swear by the gel and if the tablets suited you then fine to take them again! (That wasn't much help was it?!!!).
Hurdity x :)
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Hi Hurdity and Cazikins
I completely folded at the appointment, I couldn't go through with it. I was up all night, nerves and all, tried to convince myself to go for it, that's it's the best option but I just broke down.
The doctor was very sympathetic, he did another internal scan at my request, measured endometrial thickness 8.7mm (it was 6mm a couple of months ago) and located a small polyp that the other consultant had suspected before. So this good doctor says it's okay to wait with Mirena if I'm not ready and that anyway the polyp should be removed first and he is scheduling Hysteroscopy very soon, and Mireba could be fitted later, depending on the findings.
The nightmare continues, I am scared witless, I just want to hide and run away ...
So hyperplasia and polyp are caused by too much estrogen but at the same time my sudden severe menopause was caused by sudden drop in estrogen... I wish I could make sense of it all ...
Ladies sorry for my rant, and thank you for support xx
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Andie - it is all very confusing and frightening at times but your symptoms, and even the hyperplasia/polyps, are very common when meno hits and really nothing to worry about. Peri meno and early post meno result in fluctuating hormones and this is what is causing all you problems - this is very common - it's a shame we women are not educated better about what to expect at this time in our lives. Thank goodness for this site - we are here to support you.
The polyps can be treated and the Mirena is now a standard favourite of many gynaecologists because it protects the womb lining so well and solves many of the problems women have with progesterone and erratic bleeding.
For the short term it may be worth discussing some sort of anti anxiety treatment with you doctor to get you through all this, as it has clearly frightened you so much. Thank goodness you had a better doctor at you last procedure.
You have done so well to get this far - you've had such a fight.
Have you every learned Mindfulness or other relaxation techniques - I rely on these heavily.
DG xxx
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Hi Dancinggirl
Thank you for your post, you are right, it is such a shame we don't know more about it when menopause hits, but at least there are signs now that things are changing, thanks to Dr Currie's work, patients' pressure on doctors, accommodating menopause at workplace etc.
I do not dare to go to the doctor for any pills - I have never taken so much as a painkiller until I had that biopsy, and of course the HRT. It really seems that the moment you end up in the system, they want to monitor/test/check/invade every possible body part and prescribe something for it to 'treat it', and then take it away causing another problem, or prescribe something else to treat that, it's a vicious circle I want to avoid. They practically pushed the HRT on me at first, then 3 months later when I came in for repeat prescription, it all started because that doctor didn't know that Elleste Duet sequential is meant to cause monthly bleeds. So he ordered me to stop HRT immediately, to run a 6 week experiment to 'see if bleeds stop'. That's how it all started...
I am seeing my counsellor again (on and off most of my life) so that's been helpful, and I am trained in autogenic training (self-hypnosis/relaxation) but it doesn't seem to work for my anxiety - in fact, the HRT calmed me down like nothing ever did. It is the constant threat of doctors wanting to take it away that's been driving me demented for months. With anxiety, I find anything that encourages self- focus makes it worse, so meditation, self hypnosis, mindfulness seem to have the opposite effect, but I do write a journal to calm my nerves, deal with negative emotions, stop panicking - it helps but the past few months keeping calm has been a full time job!). Also, I will be working on the issue with the counsellor some more - you know, I have survived childhood abuse - physical, not sexual) by my own parents, I stopped it aged 19 when I finally left home, found a job and started building my own life. A lot of people like that end up on alcohol, drugs, I never did, so it is such an irony that I somehow managed to get through all that, build a life for myself, get married (no kids though, my own choice), but I fold at these gynaecologist exams/treatments. Normally I am a rational person, I understand science well ( studied it) but being a patient freaks me out completely. if it was my arm or my ear or something else, I would quite happily let them poke around/dissect/cut bits out, but women's things really take me to a bad place...definitely matter for the counsellor... Took me years to recover (mentally) form abnormal cervical cells op, (CIN3) 18 years ago, so it's like a bad dream repeating itself.
What scares me so much is that doctors seem to disagree with each other, won't look at the whole picture, stick rigidly to guidelines that were written for a typical menopause age, not early one at 44, so we have been dancing in this vicious circle for months now - something always crops up, one doctor says ET has to be 3-4 mm max, another says no, even 8.7 is okay if you are on HRT. One says must have Mirena, the other one says, no, it wouldn't help and I would probably expell it anyway, polyps needs cutting off first. It is the wait that is so hard, now I'm 'catastrophising' what if the polyp is going to be cancerous or pre-cancerous (I know it's rare, but...), in which case it's still going to be a ban on HRT so my HRT future is nowhere near secure.
Before I went on HRT I suffered meno symptoms for 2 years, but at least that was my choice. Now that i've seen how HRT sorted all the symptoms and literally gave me my life back, the thought of having it taken away is driving me mad (and furious).
I will have to have this Hysteroscopy and polyp removed, and Mirena inserted at the same time, but the more i'm reading about it, the more it seems I should have GA, but that's scary too, so my head is like a washing machine hurling everything round, and of course I have a job to do, a business to run, and at least appear sane... I wish I could just laugh about it...
P.S. I thought I'd be dealing with something like this aged 60 maybe, not in my mid 40s, I am exhausted by the battle, the wait, not knowing... Can I please have a crystal ball?
Thank you for your support, hope I'm not a burden.
Andie xx
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Andie - my menopause started in my mid 30s so I quite understand how you feel. I have seen so many doctors and specialists over the years and opinion differs so much. You are, quite rightly, asking for an holistic approach from the doctors and sadly this isn't what we get. I have had erratic bleeding, awful cramping and all kinds of problems with HRT as well but I am pleased I persevered as, at 62, and now 2 years without HRT, my joints are really going problems. I dread to think how bad things would be now if I hadn't used HRT til I was 60. The Mirena with Oestrogel was my best HRT regime and gave the fewest problems.
If HRT makes you feel better, then HRT is what you need. You just have to get the polyps sorted (these are quite common) and decide whether you want the Mirena or not. Perhaps you can work with your counsellor over this so you can prepare yourself better when you have your polyp procedure.
I came close to a breakdown soon after my meno started in my 30s (so much stress going on in my life at that time as well) and had counselling for a year and it really helped me through.
You have had good advice and support from Dr C, you have fought hard to get this far and you are clearly a survivor.
Stay positive, decide what you want moving forward and go for it. Good luck. DG x
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Hi AndieKC
Re endometrial thickness - if you are on cyclical HRT then your lining will vary depending on the stage of the cycle you are at. However if you are post-menopausal and on continuous combined HRT then it should stay uniformly thin (below approx 4 - 5 mm i thought?) so 8.7 is generally thick. Bleeding is usually the sign that something is amiss and especially bleeding after 6 months on continuous combined hRT when the womb lining should have settled down to a standard - lower thickness.
"So hyperplasia and polyp are caused by too much estrogen but at the same time my sudden severe menopause was caused by sudden drop in estrogen... I wish I could make sense of it all ... "
It is the balance which is crucial not the amount per se - so if you have insufficient progesotgen in relation to the amount of oestrogen - that manifests itself as "too much oestrogen". It is best to have the (minimum usually - depending on age and your medical history) dose of oestrogen which most effectively deals with the symptoms you are trying to control. Then once you have got this right you need to take the correct amount of progesterone to keep th elining thin. Sometimes on the combi conti products it isn't right for some women hence the need to change and as discussed and as Dancinggirl's experience - the Mirena would do this.
Just to give my experience - I had some spotting and had hysteroscopy and biopsy to check womb lining. I opted to have this done under no anaesthetic but I had to sign a paper to give consent for removal of polyps at the same time if they found any - which they didn't. The gyane also said did I want a Mirena coil and he would have inserted one all at the same time - so it is possible to do everything at once.
Sounds like you are a really strong woman with all you have gone through so hope you manage to stay strong until you have your treatment sorted.
Take care
Hurdity x
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Hi Hurdity, Dancinggirl and all the other kind ladies who have replied...thank you soooo much! New information has come up and I'm confused.
(Just completeda year on Elleste Duet 1mg sequential, today switched to Kliovance with Noriday (for extra progestin) as recommended by Dr Currie and prescribed by my Gp until Mirena can be fitted, and I'll have a low dose estrogen).
Initial scan 6mm thickness which started the whole merry dance of scans, biopsy etc. Now new scan was done and the dr says that my lining looks normal and thin !!! but in one place it's 8.7mm, but he is not worried about it as i was still on Sequential HRT but there is something that measures 10mm that could be a polyp, which could explain the odd spotting I had.
Hysteroscopy suggested with polyp removal, and Mirena insertion at the same time (I want it done underGA).
So how did the 6mm trigger all the hysteria, yet now consultant says he is not worried about 8.7mm... he said he would be if it was 30mm... By the way, never been measured after a monthly bleed, always before.
Biopsy showed ‘simple hyperplasia without atypia so does anyone know :
if Endometrial thickening usually means all over the entire uterine lining or just in places?
Is endometrial thickening the same as hyperplasia? I know there is simple and complex hyperplasia, with or without atypia.
If 8.7mm is not of too much concern, does it mean the polyp is a big problem?
Could it be cancer?
I had a bit of spotting and some monthly bleeds were a little heavy compared to my real periods before menopause which were very mild but apparently on Sequential HRT erratic bleeds can be quite common?
As I was nearly 2 years after my periods stopped when I started sequential Elleste, could that have caused erratic bleeds? (continuous combined hrt would have been a better choice I understand)
P.S. I have been having a clear, watery discharge, it feels like excessive lubrication, but no hint of blood or any colour. It's been quite constant in the past couple of weeks, sometimes it makes me think ah, bleeding starting, but no, it's just a big of liquid I can feel. I've read somewhere that hyperplasia/uterine cancer can cause pink discharge but mine is just really clear, literally like lubrication, so getting worried now.
Did your polyps cause any symptoms?
Thank you, hope it's not too much information xx
, so I can understand
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Hi Andie
First let me say that I'm not an expert or a doctor , but I think the sequential hrt is possibly responsible for your bleeding. Hopefully your body will settle on the Kliovance and you won't get any bleeding.
I think HRT can cause more discharge too as it lubricates parts that have become dry.
I know it's hard but try not to overthink things. I'm terrible for needing to know all the ins and outs of everything and I have gone round and round in circles with all my problems caused by menopause . Now I'm settled on a hrt regime I am beginning to calm down and not think so much about the whys and wherefores of it all. But I know it's hard.
I'm not sure if I'm helping you! It's such a complicated and awful time of our lives, but there is light at the end of the tunnel. Xx
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I agree Jeaniewigs. We are here to support on this forum. And just someone giving you a few words of encouragement makes such a difference. Nothing is right or wrong on this journey. X
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Hi AndieKC
I do agree with Dotty that it's best not to overthink but I do understand your desire to understand what is happening as I am the same!!!
Re the difference between endometrial hyperplasia ( ie simple without atypia which is nothing to worry about) - and the normal thickening of the womb lining that happens during the menstrual cycle ( and including the artificial cycle when on HRT) I have never really got a satisfactory answer from my research around the web.
When I had to have investigations that led to hysteroscopy and biopsy (due to spotting after sex) - I had a scan which showed thickened lining ( only to be expected as I was in the middle of long cycle HRT!), but the TVS showed an abnormality hence they sent me for investigations. In this case it would present on the scan as a thickening but they could see that it was a defined irregularity. It runed out to be a small fibroid which has since disappeared or is so small as not to be found on regular scan.
I don't know about irregular thickness otherwise.
Also I'm not sure why you think it might be cancer as I thought the biopsy showed simple hyperplasia without atypia? However if you have an area that could be a polyp then it is important to have it investigated and removed if necessary and that would put your mind at rest.
If you start sequential HRT 2 years after menopause then your bleeds should be more predictable - but on oral HRT there can be differences in absorption (it has to be digested before any of it gets into the system) leading to inconsistency in systemic levels which could possibly account for this.
I have no idea whether polyps cause any symptoms apart from bleeding - sorry, nor about the discharge!
I assume you are still having the polyp removed during the hysteroscopy?
Do try not to worry - you won't be able to find out what exactly is going on in your body until after the procedure so try to do something to take your mind off it all!
Hope this helps :)
Hurdity x