Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: toothbrush on December 21, 2018, 01:27:25 PM
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Hi ladies , had my scan results back today as had post meno bleed . Ovaries are fine but I have an endometrium thickening at 20mm!!!
Super scared it's something nasty. GP has sent letter today to gyne for hysteroscopy ? and biopsy
Scan said difficult due to axial orientation ? And also contains a 13mm posterior intramural fibroid.
It says endometrium appears otherwise regular in outline . No free fluid or adnexal masses seen.
Gp only seems concerned about the lining thickness , which after reading other people's info is v v thick .
My health anxiety is through the roof 😥
Been on femseven conti patch half patches for year and half. Before that femseven
Sequi. And short time elleste and Femoston. I am 52.
Anyone else had similar ?
Very frightened
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Why don't GPs explain!?!
It is thickened. Probably due to the HRT you have been prescribed. Did the GP give any idea when the next investigations will take place? Did the GP give any idea of what 'normal' might be on this particular HRT?
:bighug:
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Hi, thanks for replying
To be fair the GP was lovely , she told me should be between 4-5mm so mines definitely thickened 😥
She has sent referral letter and I should get appointment within 2 weeks . I have to stop my hrt too .
She also said there was nothing else seen ???and didn't seem bothered about the fibroid at all, which sounds good fingers crossed . Told me to try not to worry ....... but that's impossible for me xx
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Hello toothbrush,
Maybe your own hormones are playing up. You are 52 and that's the turning point for most women when the ovaries go haywire. I guess a sequi regimen should have been more appropriate for your age. Stopping HRT may give you a bleed (fingers crossed). I hope the hysteroscopy/biopsy shows everything is ok. I know it's impossible not to worry, but you're having symptoms of high oestrogen and not from cancer, ie bleeding. Keep your mind focused on something else and just deal with this after the results.
Conolly X
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Hi I have been through similar myself recently and anxiety goes through the roof. My bleeding stopped as soon as I stopped hrt and the thickening I had went down after a few weeks without further bleeding. All the waiting adds to the stress, and not a good time of year for this when everything seems to stop! My bleeding was from too much oestrogen, so try and be positive. I know its hard because I was anything but positive at the time and still feel anxious about it all. This forum helped me so much , and still does, so keep posting. All good feelings to you.
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Thankyou . I know it's so stressful especially at xmas which seems to make it worse .
I had no bleeds when on the sequi for about 14 months so I believe that's why doctor changed me onto conti . The bleeding had stopped but the whole month was weird in November , awful breast / nipple pain , huge spot on chin lol ... felt like a teenager again , spotting then two weeks later like a proper period . Very odd.
I had tried some vagifem pesseries also at beginning of month but dr says shouldn't have caused bleeding . Maybe using only half a patch has something to do with it ? Just worrying as to what outcome will be . I am trying to get on with work things.
Only saw dr this morning and received text just 5 mins ago with appointment for 2nd Jan . Can't knock the NHS on this occasion . Mega fast xx
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Good advice here. Less worried?
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Yes thank you . Although I always think worst case senario . Had a few cancer scares , first with thyroid being highly suspicious even till after removal then finally letting me know it was all benign , and this year had first mammogram showing lumps I didn't know I had . 2 week appointment , biopsys but again luckily benign . I am becoming a big lump of medical terms 😃
just wish my scans could have been done in a gyne dept initially and further tests done on same visit . It's the going round in circles sometimes .
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I think it's that the Depts don't talk to each other ::)
:foryou:
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Hello again toothbrush,
Did your GP/Gynae tell you why you didn't have a monthly bleed for so long while on the sequi regimen? I don't mean to worry you, I'm not an HRT 'expert', just curious.
Conolly X
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I know , the depts don't seem to communicate possibly . I thought for post meno bleeding gyne had like a "one shop' style system , but maybe not here .
With regards to sequi lack of bleed , my femseven sequi information sheet said sometimes up to 15% of women won't get a bleed ( or something like that ). Doctor didn't seem concerned . Went on the femseven sequi after
I stopped femostan tablets cos of heavy periods and dr suggested going down the patch route . I didn't have the evorel patch as the ellest duo I had right at beginning made pmt really bad ( think that's the same progesterone ?)
Cos dr has told me to stop my hrt today should I expect a bleed?
When all the weirdness started in November I was 4 days late changing my half patch , unless that has messed everything up . Doubt that would increase this lining so dramatically tho?
Nearly fell of the chair when she said it was 2cm!!! 😲
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Tootbrush,
As I said before HRT is not my expertise... you have been on a lot of different progestogens though. Femoston has dydrogesterone, Evorel and Elleste Duet have norethisterone, and Femseven has levonorgestrel. Although their primary purpose is the same, ie to oppose oestrogen activity in the endometrium, I reckon they are different and can have different actions and side effects, so maybe your body didn't react well on the changes.
As I understand, the 15% of women who don't get a bleed won't have a thickened endometrium.
All your symptoms point to excess oestrogen, so maybe once you get rid of the excess, you'll be fine to restart HRT again.
One of the non pregnancy related differential diagnosis for a thickened endometrium is HRT, I think that's the cause of yours. Another one is PCOS, but I guess you don't have any symptoms?
Conolly X
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Thanks conolly, yes no other symptoms .
Will be interesting to see if bleeding or spotting starts now dr told me to stop the hrt for now .
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Hiya, I only used half a patch as wanted lowest amount of hormones and gp said was ok , but I do now think maybe it hasn't been enough ? Although main symptom I initially went on hrt for was the flushes which seem to have been controlled with this small amount . Only had the one episode of strange month in November with very sore breasts , some spotting then into a proper type of period .
No spotting or bleeding since . But I know 20mm thickening is not normal 😔 . Super anxious
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It's all a bit gobbledegook to me lol! Not really sure what's going on but will report back after appointment to let people know . Hoping it's simple hyperplasia but can't stop thinking worst case of cancer .
Trying to be calm .... and I am keeping busy..... but must stop googling 😔
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Yes stop googling, it will drive you bonkers! It's an awful thing to go through. My stress levels went through the stratosphere for 3 months and still feel exhausted and anxious. I thought the worse as well, I think it's only natural. I hated that feeling of losing control of my body and the health professionals taking over. It all felt so alien. Try and cope as best you can and all the best to you.
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Hi, did you have scans etc Suzy?
Its bizarre how our bodies work.
Thank you I will let forumkniw outcome. Best wishes
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Hi toothbrush - if you didnlt get a bleed on the sequi HRT then you weren't ovulating and the progestogen in the patch was sufficient to keep your lining thin.
The fact that it has thickened now sufficiently for you to bleed could either mean a late ovulation - (since you can't know exactly what your body was doing naturally after starting HRT - and by late I mean late since you/your doc feel you were post-menopausal enough to take conti HRT) or oestrogen breakthrough bleeding either because it has thickened and is shedding spontaneously or due to the large fibroid. It's not a question of age but stage - although spontaneous ovulation after the 12 month period of time without natural periods is more likely to happent he further away ( younger) you are from the average age of natural menopause. This is why contraception must be continued for 2 years if periods stop under 50.
The fact that you had pre-menstrual symptoms followed by a proper period 2 weeks later is indicative of ovulation which would well explain the thickened lining. After all half a patch is very low dose and definitely will not be the cause of the lining build up.
Also to correct a misapprehension - it has not thickened from too much oestrogen per se, but from an excess of oestrogen over progestogen (or the fibroid or both). You can have very high doses of oestrogen and your lining can stay thin provided the progestogen dose is sufficient.
From what I understand in fact a thickened lining does not necessarily mean endometrial hyperplasia - although I am still not sure whether a thickened lining with no problems is just simple hyperplasia without atypia ( ie cells are normal). I think a thickened lining can be just that.
My bet in your case is that it is a natural period (half a patch will not be anywhere near sufficient toi override your natural cycle) + the fibroid.
It is not true post-menopausal bleeding as such but more like unexpected if you see what I mean. The doc is right to refer you but most likely absoultey normal - as you say the doc couldn't see anything - but hopefully once you;ve had hysteroscopy and biopsy this will be confirmed. If you have started ovulating then the thicekend lining does not need treating - although if you then have anovulatory cycles (when you won't produce any progesterone of your own to help sehd the lining) it might be better to have a decent dose of prog ( as well as oestrogen) and have a full patch. I can't see why you would want half a patch especially at your young age when many of us are/were still menstruating normally (I was).
By the way you do not need to stop HRT (my doc said I had to but wrote to Dr C here who said I did not, and took the email to my doc) pending the investigation and stopping it may well cause a bleed as you will be reducing the progestogen levels signalling to the body to bleed - especially as it is thick. Personally if you don't want to bleed over Christmas period ( maybe too late if you;ve already stopped!) then carry on with the half patch.
A thickened lining as Stellajane says is no big deal if everything is pronounced normal - you just treat it with progestogen to thin it if necessary.
Hope this clarifies and helps rather than confusing and do try not to worry!
Hurdity x
PS sorry for typos - too busy to correct them all!
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Thank you hurdity. You info is very clear , I definitely hope this is the reason .
Is it possible to ovulate after such a long period?
Thank you for your reply , and for everyone helping me with my level of anxiety . I shall let you know results , once again thank you
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Yes I had 2 intra vaginal scans with a biopsy in between. They wanted to do a second biopsy as they didn't get enough tissue with the first but I couldn't face it. The second scan showed the lining had gone to normal. They weren't happy that I refused the biopsy.
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that's great to hear your lining went back to normal suzysunday. fingers crossed everything ok settled for you now. I don't feel any different and am not having any discharge now or any other symptoms. I have stopped the hrt and will be interested if another period like cycle starts again - in November I didn't change my patch on usual day - was 4 days late- I was toying with idea of coming off the hrt as no flushes anymore but bottled it and stuck patch back on . its just such a scary time and when you see the radiographer for the scan they really wont say anything, which makes me panic when they tell me to see my doctor before Christmas (when I saw them on Wednesday). will keep in touch with more info . thank you for replying
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The 2 radiographers I saw were willing to tell me what they saw, which was really good. I don't think they are supposed to. It was the gynaecologist who was very uncaring. Anyhow, all the best and try and enjoy something of Christmas 🎅.
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Have a great Christmas and new year , will keep in touch
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hi everyone , just an update. went to hospital to see gynae - with regards to thickened 20 mm lining. didn't see consultant - saw another doctor- registrar? . history taken and she did abdominal check - then attempted to do endometrial biopsy - but unable to do due to cervix closed. I couldn't really feel anything , not as uncomfortable as a smear, but she didn't really try for that long - just said couldnt do due to cervix being closed and I would need to come back for a hysteroscopy with possible anaesthesia/gas and air - and cervix would need to be dilated? sounds horrid tbh but hoping as I didn't feel much today it wont be too bad. she said cervix can close especially as I had not had a vaginal birth with my son - he was caesarian. I then saw she had drawn something on the patient notes - so now panicking something wrong with what she saw but when I asked she said it looked normal and common in menopause. this is dragging on and just adding to my anxiety but I have an appointment for Friday which is super quick - only 2 days thank goodness. shame they couldn't have done today as I was kinda prepared for it. I am seeing a nurse specialist who will be doing the hysteroscopy. so another few days of worrying and then a wait for results - just want finished
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:bighug:
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The waiting is awful. The whole process for me dragged on 3 months. Hope all goes well. Can't write too much as not feeling good with anxiety and goodness knows what..
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Thanks for replies ladies .
It's just so damn stressful . I just wish my area had clinic to do all testing on one day . Just to get it over with and done .
Hope your anxiety settles Suzy .xx
Onwards to Friday 🙄
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Hello toothbrush,
Fingers crossed for you 🤞🏻🤞🏻🤗
Conolly X
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Thanks Conolly. Trying to keep busy today but stressed for tomorrow 😩
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Absolutely normal. Don't fight your thoughts, just let them flow through your mind and have some nice treats in between them. :love:
Conolly X
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Thank you hurdity. You info is very clear , I definitely hope this is the reason .
Is it possible to ovulate after such a long period?
Thank you for your reply , and for everyone helping me with my level of anxiety . I shall let you know results , once again thank you
Hi there - sorry I didn;t reply to this. It's difficult to say - since you started HRT before you reached menopause, but natural ovulation after 18 months - say of no periods - is possible. The cut-off date of 12 months to trigger investigation - is to ensure that no cases of potential endometrial cancer are missed - and does not mean that every woman who bleeds ( or has thickened endometrium) after this time - will have cancer. In fact the incidence is very low and bleeding often picks up endometrial hyperplasia way before cells become cancerous . Once you start HRT the picture is far from clear anyway, and especially with abormalities such as fibroid as already mentioned, which can cause bleeding.
Anyway all the best for tomorrow and hoping all is well.
Hurdity x
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Hope all goes well for you tomorrow and you are given the all clear soon. It's about 2 weeks for results where I am, so more waiting for you. Not much of a Christmas for you with all this.
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Thankyou everyone . Update is had hysteroscopy today . Local anaesthetic into cervix and then dilated then camera and biopsy . Apparently there is small polyp, but only about 2nm.
Nurse specialist said lining looked fine, smooth,
nothing to see . She made me feel much better as was
quite reassuring nothing
nasty seen but obviously we must wait till biopsy results through which apparently
take about 10 days .
The hysteroscopy really wasn't that bad tbf . I did ask if she could remove the polyp while I was there but she said not . Bit of a shame if got to go through it all again tho .
Will let everyone know next outcome
Thankyou everyone for keeping me sane
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So far so good. It's good when you can get these appointments out of the way.
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Tnx for the update. My polyp disappeared on it's own, the Consultant wanted to take it out but I wasn't mentally well enough to face surgery. Once I hit peri the polyp went ;)
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Aren't our bodies strange!
I have felt fine today just very slight cramp , but really nothing .
I stopped the hrt when initially seeing gp and am feeling ok with that too...... at the moment lol. We shall see !
If I continue to feel ok I will probably not restart my patches once everything settled with outcome .only using half patch femseven conti I was told if everything comes back normal then it may have just been a random period and that I then start from that date as ‘last bleed' . I was concerned if keep getting random bleeds ( although I have only had one - and nothing since that one in November ) would I have
to keep going through this s..t 😢. Apparently only if a year after for another bleed .
What baffles me tho is according to nurse lining looked smooth with nothing to report yet scan said 20mm thickened . So can it be super thick but appear healthy? Unless biopsy proves otherwise / hopefully not🙏
Having a glass of wine 🍷 tonight as husband and son appear to have ‘man flu' 😩
It's been a long couple of months 😢
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Hello toothbrush,
Glad to hear everything went smoothly and you're feeling OK. Fingers still crossed for biopsy results. :-*
Conolly X
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Thanks for the update toothbrush - and glad all sounds OK. What a pity they couldn't remove the polyp - when I had a hysteroscopy/biopsy it was done by a gynae at the hospital and I had to sign a thing saying it was OK to remove a polyp if they found one - so only needing to go in once - which does sound like a better plan! However hopefully all will be well when you have your polyp removal!
Let us know the outcome!
Hurdity x
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I know hurdity, it's a shame to have to go through this all again , unless she really felt they may just leave it as so small? Or perhaps she was running late and it meant more time ? Does anyone know if cervix would have to be dilated again ? Does it close up quickly?
She even said it may have gone off in biopsy 🤨
Still a bit anxious for results but definitely calmer . Luckily I took a friend in with me and it's interesting how much you ‘don't ‘ hear when they are talking to you . It's as if I was zoned out lol . Onwards and upwards for the new year and I know how lucky I am to have such great support in this forum no matter what the outcome is 😘
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Hi everyone, just a quick update on results . All normal , benign and no further treatment . I have decided to try without my hrt patches as was only using half and see how I get on, although the flushes seem to be returning 😕😕😕.
Thankyou for all the kind comments and support whilst I was going through this anxious time .
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Good news toothbrush - hope you get on OK :)
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Thanks for the update toothbrush - glad all is well. I hope you feel OK off the HRT - but if after 3 months or so you feel a lot worse then perhaps think about restarting ( can't remember your age....) but it would have to be something different as Femseven conti is unavailable and being redeveloped.
Hurdity x
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Glad things are ok. I came off hrt after pmb and biopsy as it does scare you. I just use local hrt for VA but it's a struggle to get on top of the VA and the flushes etc. I am going to give the local hrt a good go and hope it is enough. These decisions are hard when you have been scared with your health.
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Thanks everyone , yep the flushes are a damn pain . If I go back on again do u start all over again if coming off again ..... like Groundhog Day lol
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Who knows! Probably!
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OMG :o
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Thanks everyone , yep the flushes are a damn pain . If I go back on again do u start all over again if coming off again ..... like Groundhog Day lol
Not necessarily - some women always get them when they come off HRT way post-menopause. Other women might get them for a short while but then they ease off and stop. Aome other lucky women may not get them at all when they stop HRT. If you are still peri-menopausal then if flushes led you to start HRT you would most likely keep getting a return of them in any case while peri-menopausal, if you stopped hRT before you reached menopause.
Anyway - it's the quality of life while you are on the HRT that is important - you can't take those years away, whatever happens when you stop somewhere down the line!
Hurdity x
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Hello toothbrush,
How are you doing?
Conolly X
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The flushes are back 😥
Boooo
Bought some starflower tablets and some sage ones yesterday to try . Sceptical tho lol
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Some days aren't bad , but others are a beggar. But havent had a decent sleep for weeks 😡
Stress definitely makes worse .
Off for ‘well woman' check in couple of weeks ....... hmmn don't feel particularly well with deprived sleep lol!!!