Menopause Matters Forum
Menopause Discussion => Other Health Discussion => Topic started by: Dierdre on December 10, 2019, 10:03:16 PM
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Just had my scan results today and was surprised to be told i had small fibroid and signs of endometriosis. I'm ten years postmeno and never had either of these things ever before, no symptons other than pelvic pain that lasted about six weeks, hence the scan but have been pain free now for about a month. Doctor said she wasnt concerned but writing to my gynae to ask if we need to follow up or do nothing and monitor. Ive had no bleeding at all and im only on vagifem and ovestin so confused whats made these grow as its usually oestrogen. I had a scan 2 years ago and it was completely clear. Anyone else developed this postmenopausal?
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At the age of 62 I was definitely menopausal. I was prescribed Vagifem and this was not for me. My GP now prescribes SYLK for vaginal dryness which I use once a day. SYLK does not cure vaginal atrophy it does help make things more comfortable in the vaginal area. If you are concerned go back to your GP and ask for reassurance.
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Update after seeing gynae yesterday. I havent got endometriosis, the scan shows an ill defined 8mm portion of the lining. Going for another scan next week to determine if this is fibroid tissue and that the rest of the lining is less than 5mm. If so, no action and to monitor as no other symptoms. Anyone else had this, they dont seem overly concerned and told to carry on with Vagifem and Ovestin as normal.
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Hi Deidre
Do you take hrt?
I took it for a short time, but stopped it as it caused multiple problems for me, one of those being that it caused a fibroid to grow.
As far as I am aware estrogen causes the lining of the womb to thicken and it can also cause the growth of fibroids.
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Hi Jari,
Ive been on local estrogen for 5 years and the gynae said its such a minute dose so not connected. I did take full HRT (conti Femseven patches) for six months but stopped over 18 months ago. I had a scan 2 years ago before going on full HRT and all the lining was 4mm then so this portion has grown during the last 2 years.
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Hi Deidre.
I took the gel estrogen just 2 pumps a day, which I reduced to 1 pump a day because of the trouble it was causing me. I only took it for nearly 3 months and in that time it caused a fibroid to grow.
The gynae i saw said that she had seen a lady where her fibroid was hiding a cancer growth, so she told me I should have it removed. I chose not to and since stopping hrt it has gone.
I might have another scan at some point just out of interest to have a check..
The gynae wanted me to have the scan after coming off hrt to check how thick lining was and if I needed progesterone which sheds the lining causing a bleed.
Difficult to get the right balance I think and definitely worth having regular scans when taking hrt. X
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So it could have grown while i was on the full HRT for 6 months and will take time to shrink. Ive no bleeding or other symptoms and wouldnt have known if I hadnt had the scan, I will have a biopsy if they are still concerned after the scan.
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Yes I'm sure you?ll see on the scan. If you are off the hrt I am sure it will shrink on its own.
Estrogen causes fibroids to grow so as we get older we do not tend to have trouble with them with our naturally reducing estrogen levels.
X
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Fibroids normally shrink after the menopause. Existing Fibroids usually do not shrink if on HRT and sometimes they do grow (Dr. Louise Newton's website). If HRT is discontinued Fibroids usually begin shrinking.
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Hi Birdy. That is good you have had a scan to show that yours has not grown.
I have a history of estrogen receptive cancer in family so I have always had regular scans.
Before I took hrt I had no fibroid. After hrt it was there, albeit small, but apart from that, it was my gynae meno specialist that told me hrt caused it to grow. Fibroids are estrogen dependant as are some breast cancers.
I also had a bone scan last year which was interesting.
I am pleased that your hrt has not caused you any problems.
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Hi Birdy. That is good you have had a scan to show that yours has not grown.
I have a history of estrogen receptive cancer in family so I have always had regular scans.
Before I took hrt I had no fibroid. After hrt it was there, albeit small, but apart from that, it was my gynae meno specialist that told me hrt caused it to grow. Fibroids are estrogen dependant as are some breast cancers.
I also had a bone scan last year which was interesting.
I am pleased that your hrt has not caused you any problems.
You mention a bone scan. One of the advantages of HRT is to prevent osteoporosis. One of the reasons why I am trying it apart from VA.
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Hi Katejo.
Yes I did hear that hrt can help for osteoporosis. I think that when you stop hrt those benefits are lost. The risk of fractures, I believe, are greatest around the age of 75.
I do not take hrt but my bone scan showed no problems for osteoporosis, but I will likely have another scan in a couple of years. If it shows the start of osteopenia at any point in future I will increase calcium intake and possibly drugs for osteoporosis if it might be a problem.
Have you had a bone scan Katejo? Are you at particular risk of osteo?
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Hi Katejo.
Yes I did hear that hrt can help for osteoporosis. I think that when you stop hrt those benefits are lost. The risk of fractures, I believe, are greatest around the age of 75.
I do not take hrt but my bone scan showed no problems for osteoporosis, but I will likely have another scan in a couple of years. If it shows the start of osteopenia at any point in future I will increase calcium intake and possibly drugs for osteoporosis if it might be a problem.
Have you had a bone scan Katejo? Are you at particular risk of osteo?
My last scan showed mild osteopenia and I take a low dose of Tegretol which can affect the bone density.
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Update after seeing gynae yesterday. I havent got endometriosis, the scan shows an ill defined 8mm portion of the lining. Going for another scan next week to determine if this is fibroid tissue and that the rest of the lining is less than 5mm. If so, no action and to monitor as no other symptoms. Anyone else had this, they dont seem overly concerned and told to carry on with Vagifem and Ovestin as normal.
Hi Dierdre - I see the topic has moved away from the subject of your post - fibroids but yes I'll tell you my experience.
I had some spotting after sex a few times about 7 years ago (6 years after starting HRT). Was sent for scan. Showed thickened lining (to be expected as I was on cyclical HRT so it was at the part in my cycle where it would be thicker). The Transvaginal scan showed an irregularity in the lining so was sent for hystersocopy and biopsy. The hyster showed that I had a small fibroid of 0.8 cm (ie 8 mm) and biopsy was all clear - so that was unlikely to have been the cause of spotting. I am on full systemic HRT medium dose patches and have been for 13 years now.
For reference a relative had a big one in her early 60's which was the size of a grapefruit and she had to have a hysterectomy.
A few years later - last year - I bled on the last day of the combi part of my cycle so mentioned to doc at my HRT review and said i was worried if the fibroid had grown so had another scan (TVS) and in fact the fibroid had shrunk to 0.6 cm (6 mm) after a fuirther 6 years (on full HRT) not grown.
So the position is that taking HRT MAY cause existing fibroids to grow but NOT necessarily and as I say mine shrunk. If you already have large fibroids at time of menopause then maybe continuing with medium to high dose of HRT will mean they don't shrink or maybe grow but most definitely depends on each individual circumstance.
In any case if they are not bleeding and not painful then there is not a problem anyway. As far as I know fibroids are harmless if left and it is only polyps that need removal in case they become cancerous.
So all in all Deirdre I would say hopefully nothing to worry about - although I would always accept investigations that are offered as it's always good to know about our innards ::).
Hurdity x
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Hi Katejo. My bone scan showed borderline osteopenia in spine but they said no need for anything at this point. Interesting re your med, I will keep a note of that.
Re fibroids, Deidre I took oestrogel and I do not know how that compares to your Ovestin. Do you have a leaflet in the box it comes in?
For oestrogel re fibroids it says:
Warnings: tell doc if ever had migraine, fibroids, high blood pressure etc etc list goes on... it says these may become worse during treatment with oestrogel. If so you should see your doc for more check ups.
It also says when you have mamograms to make sure to tell them as oestrogel can increase density of breast and the mamograms may therefore not detect all lumps.
This is for oestrogel, but it would be interesting to know what it says in your leaflet for ovestin? X
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Thanks Hurdity, I was on full HRT patches a couple of years ago for 6 months after a clear scan, so a fibriod could have developed then and hasnt completely shrunk yet,. Scan a week on Wednesday so will update then.
Jari, the gynae said local estrogen dosage is too tiny to cause fibroid growth, but i think the Ovestin leaflet will probably state the same as full HRT anyway.
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Ok Dierdre. Hope all goes well on Wednesday and let us know how it goes. X
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Well, had my scan yesterday and was told my lining is 6mm well within the postmeno limits, NO fibroids and a completely clear scan. I explained why im re scanning, that the previous one showed an ill defined 8mm portion of the endometrium and the gynae was concerned. She said there were no concerns whatsoever and asked me where i went for the last scan, i told her and they looked up the centre (part of NHS) looked at each other like they knew something then said Oh, its not part of our diagnostic group!
Im obviously relieved but disappointed someone is not doing their job correctly and causing me all this anxiety for weeks.
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Well, had my scan yesterday and was told my lining is 6mm well within the postmeno limits, NO fibroids and a completely clear scan. I explained why im re scanning, that the previous one showed an ill defined 8mm portion of the endometrium and the gynae was concerned. She said there were no concerns whatsoever and asked me where i went for the last scan, i told her and they looked up the centre (part of NHS) looked at each other like they knew something then said Oh, its not part of our diagnostic group!
Im obviously relieved but disappointed someone is not doing their job correctly and causing me all this anxiety for weeks.
Surprised that they said that a 6mm lining was well within the post meno limits though. Mine was 5 mm and I was told that anything above 4.5 mm needs a hysteroscopy.
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I queried this also and she went on the computer to check then confirmed a limit of up to 11mm is ok for a postmenopausal women without bleeding or any other symtoms. As my last scan a couple of months ago showed parts were 8mm but now all is 6mm, it seems its thinning and she agrees the thickening could have been from being on full HRT and it takes a while to thin down again. I assume the limit would be different if there was bleeding involved. Ive got my appointment on Friday with the gynae so will report back.
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I queried this also and she went on the computer to check then confirmed a limit of up to 11mm is ok for a postmenopausal women without bleeding or any other symtoms. As my last scan a couple of months ago showed parts were 8mm but now all is 6mm, it seems its thinning and she agrees the thickening could have been from being on full HRT and it takes a while to thin down again. I assume the limit would be different if there was bleeding involved. Ive got my appointment on Friday with the gynae so will report back.
Mine was due to bleeding (while using Evorel conti). When I queried the 4.5 mm I was told that it shouldn't be more than 2 to 3 mm! I am waiting for a urogynae appt. now and I am going to mention it even though it isn't strictly her area. I have a meno clinic appt on Wednesday when I will definitely ask.
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Had my appointment at the clinic yesterday for my scan results and at first the doctorr wanted to do a biopsy as my lining was over 4.5mm. I told her what the radiographer had said, 6mm being well witin the 11mm postmenopausal limit for someone not bleeding , that the scan was clear and she'd had no concerns. I said i really didn't want to go through this procedure unless it was necessary with my atrophy and also when i had a my cervix opened before i went into shock and passed out. I suggested perhaps scanning again in a couple of months to see if the lining had thinned some more as it was 8mm a couple of months ago and she agreed that would be an alternative.
The doctor said the radiograhper shouldn't have shared this clinical information with me and then went off to speak to the consultant.
The cosultant then came and said as long as i see my GP if I ever had any bleeding that was ok not to biopsy and I didnt need another scan.
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Thanks for updating us Deidre.
What's with the secrecy eh? I mean bravo to the radiographer for putting you in the picture. We should be as informed as we can be by whatever source so they should not be suggesting information is withheld!
Anyway sounds like a good outcome for you :). It certainly pays to query things....
Hurdity x
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As my last scan a couple of months ago showed parts were 8mm but now all is 6mm, it seems its thinning and she agrees the thickening could have been from being on full HRT and it takes a while to thin down again.
This is interesting Deidre. I am not impressed that this doctor did not appear to know the correct mm thicknesses. Were they a private doctor out of interest?
I saw a couple of different so called meno specialists. I only took hrt for 3 months and this caused a small fibroid to grow. She was very much pushing me to make an appointment so she could remove it. She even used a scare story of another lady, where she had removed a small fibroid and had discovered a cancerous growth hiding behind the fibroid. I saw straight through her and did not opt for the (expensive) small fibroid removal. It went once I stopped hrt.
I am very weary about her wanting to do an unnecessary procedure for you to reduce lining?! Would this have cost you or was it NHS?
From what I believe, I am sure that by taking progesterone for a week, this would cause a bleed to reduce the lining? I think?!
I think you are wise not to go ahead with that procedure. X
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Jari: the uterine lining can vary in thickness, not necessarily uniform all over. As I understand it, it is areas of thickening in an otherwise uniformly thinner lining that might indicate the need for a further TVS and potentially a hysteroscopy or biopsy if it looks like an abnormality. This is what happened to me as I've already explained in the thread. My area of thickening or potential abnormality turned out to be a small fibroid as I've already said and this SHRUNK after years of using HRT. We have already gone through this. The minimum course of progesterone to shed a lining is 2 weeks usually but if very thick could be several weeks?
I don't know what you mean about a procedure to reduce the lining? Deirdre did not mention this unless I've missed something? The biopsy she refers to would be to take a small sample of uterine tissue (if there was an abnormaility or large are of thickening combined with bleeding) to test the cells for atypical endometrial hyperplasia which can lead to cancer if left.
It would be important to have such a procedure if initial results indicate it is necessary which in Deirdre's case, the consultants actually eventually agreed is not.
Jari I find it strange that small fibroid removal was suggested in your case as this is not normal practice I don't think. Only large ones that are causing problems eg pain or excessive bleeding - so I understand?
Hurdity x
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Hi Hurdity, yes I agree. As said previously, I think it was very strange that she was pushing me to have it removed.
I had no pain or discomfort or bleeding at all. In my case, I really got the impression she wanted to do it for financial benefit.
I opted not to.
In Deidre s case it seems strange and confusing if one doctor says one thing about the thickness of lining and another says something else. Why are they not following the same procedures I wonder.
Was mixing up from another post about a hysteroscopy to reduce the lining, but think it is good after all the conflicting opinions that Deidre had, that she is not going ahead with the biopsy procedure and monitor the lining thickness instead..
Wishing you well ladies. X
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Hello ladies
At the beginning of my meno journey I was found to have a small fibroid. Years later when I began using HRT I was worried that it would grow but instead it shrank and disappeared. Perhaps fibroids respond in different ways to added oestrogen in the form of HRT.
Take care ladies.
K.
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I'm on the NHS Jari, I think the doctor I saw was a trainee because she kept going in another room to ask the consultant the answers to my queries. I think she was quoting the thickness of lining for postmenopausal bleeding which is less than 5mm. Not knocking her, she was at least on the side of caution and I did think after maybe i should have had it done anyway to be on the safe side, I definately would have if the 8mm portion was still there.
Im wondering if radiographers have been told not to disclose anything they see now, Hurdity. When i had the previous scan a couple of months ago, she wouldn't tell me anything when i asked if all was ok., she just said she wasnt qualfied to comment and my GP would be in touch in a couple of weeks This made me very anxious.
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I suspect the fibroids can grow for some women in perimenopause when oestrogen surges very high, like breast cysts. Then post meno they gradually shrink and if HRT is taken it may not matter as that will never be as high oestrogen as when its surging in peri.