Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: PHW1972 on January 24, 2022, 02:46:10 PM
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any advice please. I am 49 my Dr diagnosed me as post menopause over 2 years ago when I started getting symptoms, also she kept me on the progesterone only pill as she didn't know when I went through it as I never had periods anyway, I started everol sequi last July ( everol 50 for 2 weeks then everol conti for 2 ) all was good apart from no libido and bit spotting, she wasn't worried as only been on it 3 months, she upped the everol to 75...and stopped my pill, in October. Then in December I had a big bleed lots of clots and it knocked me for 6, I read it up and it says sequi can give a monthly bleed even tho it hadn't up until then? as I didn't have periods before I started hrt I wasn't sure if it was normal. I Rang Dr's and she organised scans, hysteroscopy. They have sent biopsy off as they say my womb lining is 18mm ( way to high) now I'm so scared, can it not be that the everol 75 has made it that thick gynae didn't seem to think it would make it that thickness....my question now is I am on 3rd patch of conti now and want to know if I should go onto my everol as I don't want my lining getting any thicker, can't get a triage with my gp until after I due to put the patch on........I'm so sorry for the long post but I am worried sick
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Of course you are worried.
I would ask for an appt. to a dedicated menopause clinic; not a gynaecologist but to a Dr who works with women to ease menopause symptoms.
Peri begins 10-15 years prior to the final bleed. Do you mean that you didn't have periods due to that particular Pill? I am sure that at that thickening, you should have been referred for further treatment.
Hopefully someone with more knowledge will be along with advice. Do U keep a mood/food/symptom diary to chart progress, it can be helpful.
:welcomemm:
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U can do your own research then ask your GP to be referred or you can look at Dr Louise Newson's website for advice. There are waiting lists for most Clinics due to GPs not giving the support ladies require.
Why not ring the GP and ask or the Dept that did the scan?
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Hi Evorel Sequi is designed to give you a monthly bleed. It’s impossible to tell if you are post menopause as you were on the mini pill, so it’s very likely that you’re still in peri menopause.
The progesterone in Evorel Sequi is designed for the Evorel 50 patch. The GP should not have changed this to Evorel 75. If you need a 75 patch then you need to change the progesterone. So you could be bleeding and the lining could have thickened as you haven’t had enough progesterone. x
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On a sequi regime it's the withdrawal from progesterone that triggers the monthly bleed so you should continue the cycle as normal and hope the amount of progesterone is enough to trigger a proper bleed. Are you on evorel 75 for 2 weeks then the conti patches (which are 50) for 2 weeks?
Dotty is correct that need a different progesterone with a 75 patch, you could try utrogeston. If you don't want a bleed then try a mirena.
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Thanks Dotty and Sheila, yes she changed me from everol 50 to everol 75 and left the conti the same, so maybe that's why my womb hasn't thinned as much, she changed them in October and stopped the pill then.... I think having the pill as well as the sequi is why I have not bled at all on it until now.... she diagnosed me 2 half year ago as post by doing my hormone levels as I was struggling with sleep and sweats etc, but kept me on pill as didn't know when I had gone through it, I didn't start taking the hrt until nearly 2 years after the diagnosis as I was afraid...
Would it be best now then if I cut my 75 everol patch in half until I can get my gp to actually speak to me about it all as the first appointment isn't till after patch change?
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Can I also ask if Any of you know if my womb lining will go back to normal size if I put less Oestrogen in my body now or will the damage have been done as I know 18mm is way too thick but hopefully my cells are OK which I guess the reason for biopsy. Sorry for all the questions it's just making me so anxious thinking if it's something nasty going on
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Hi I think it’s most likely that you are still in peri menopause and do stopping the pill was the reason that your periods started again. Post menopause is when you haven’t had a period for 12 months , but you can’t count any time when you are taking hormones in any form.
You’ve also been using 2 weeks of 75 patches and 2 weeks of 50. Any change in oestrogen dose can also cause bleeding.
If you are still in peri menopause then a womb lining of 18mm is only marginally over the expected range. And if you are in peri menopause then bleeding is to be expected so there was no need for a scan.
I think the best thing to do is stick with the Evorel Sequi and get your body into a cycle. If you still think you need more oestrogen then change to a 75 patch but use Utrogestan as your progesterone.
You will also still need contraception as the HRT does not work as a contraception. I hope your GP has explained that.
Try not to worry. You have been given incorrect information and incorrect treatment by your GP. Once you are settled on a regime things should start to even out. xx
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Hi Dotty, I did ask my gp if the reason she thought I was post menopausel was because I was on the contraceptive pill so bloods would be out, she said absolutely not as I was on the progesterone only pill she could tell I was post because that pill wouldn't matter on blood results.( I did argue this case nd asked if I could be peri and she said absolutely not as my levels suggested not....
I'm thinking the bleed has come as she has put me on the sequi and read that causes a monthly bleed although I've only had 2 since new year and maybe the progesterone only pill was stopping the sequi bleed up till October.
I'm also thinking in womb lining is thick that could be as I'm on too much Oestrogen and not enough progesterone...its such hard work to know whats right xxx
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Hi unfortunately your GP is wrong . Post menopause is when you’ve not had a period for 12 months and it has to be 12 months not on any hormones.
It sounds like the pill was stopping your monthly bleeds. The progesterone pill can do that . When you stopped the pill your body started bleeding because you’re still in peri menopause, still having monthly cycles.
Your lining is probably thick because the reading was taken at the time of your cycle when the lining is at its thickest. x
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So if I was post menopause would I not have bled on the sequi patches then even though they give a withdrawl bleed do you think? Thank you for helping me with all this, that way when I get my results I know what to ask them? I will thinking I wanted try the conti patches xx
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Hi some ladies would bleed on the Sequi and some wouldn’t if they were post menopausal.
You could try Evorel Conti patches continuously, but if you are not post menopausal it’s likely that you would get breakthrough bleeding . X
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If you're peri and you use a conti regime you're very likely to get breakthrough bleeding. Could you ask your gp what she tested to ascertain you were meno? I think if you're on any kind of hormone medication you can't tell (though it's possible I'm wrong) and at 47 when she did the test it's far more likely that you were peri not meno. Given that your lining is so thick I think you would be better with a sequi regime with adequate progesterone so you bleed and thin it down. If you are meno your lining is thick enough you should do something about it.
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Hi, she did LH and FSH and from that said postmenopausal, I argued to point saying no my pill would have made the levels high but she said because my pill is only progesterone then she could see whar my Oestrogen was doing, she then repeated it 6 weeks after to confirm....I then tried without hrt until I couldn't anymore, and she said safest at the time was conti as they could tell when I had gone through it so that's why she kept me on the pill too....... when she diagnosed me I wanted to prove her wrong as I thought it was too young so I stopped my pill for couple month just to say I still having periods but no nothing came when I did that xxx
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Hi there is another thread running by a lady asking about a lining of 7mm. Hurdity has put a brilliant reply on there explaining about bleeding and lining thickness and cyclical hrt which may help you with your problem xx
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Oh I can't seem to find that thread . I am a bit useless on finding things on here but I will try again, thank you x
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Found it Dotty thank you x
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Hi
So an update even though my womb lining is 18mm all my tests were clear thankfully ;D
My gp however has said for me to come off sequi and start everol conti all the time ... when I asked her if I need something to thin my lining first she said not but also I have read on the conti packet not to take if womb is thickened.
Any advice would be appreciated please
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Hi there
If your womb lining has thickened then it is likely that you will get quite a bit of on and off bleeding on the Evorel conti. Personally in your position I would prefer to take Evorel sequi - as sheila99 suggests, to give it a few months to thin down properly through a regular withdrawal bleed. If the instructions also state this then you should take this up with the doc and say you would prefer to take the sequi. The doc should take your views into account.
As for diagnosing menopause - you won't know when this occurs. Once you start HRT - no-one will know whether they are having a cycle or when their last ovulation is, simply because you are putting extra hormones into your system. We just don't know when we reach menopause. And this does not matter at all! The average age is 51/52 and according to this website 80% have reached menopause by age 54 - but what about the other 20 % ? A few women do continue to late 50's with a natural cycle.
You cannot diagnose menopause on blood tests alone - and especially once you start adding hormone replacement into the mix - have a look at this:
"A normal level [of FSH] does not exclude early menopausal transition and a raised level does not exclude continuing ovarian function. One raised level should therefore not be relied upon as a reason to stop using contraception since egg release can still occur late in the menopausal transition.
FSH level can be temporarily raised after stopping the oral contraceptive pill or depot progestogens, during breast feeding and with some medicines such as selective serotonin reuptake inhibitors. "
https://www.menopausematters.co.uk/diagnose.php
Hurdity x
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Thank you Hurdity
no they did my levels before I started any HRT, my continuous HRT is supposed to start on Friday, at the minute I am still on the sequi and on my last conti patch, I haven't had a bleed this time so don't think my lining has sheaded so really don't know whether to start the full time conti on Friday or go back to the sequi regime ( if that makes sense ) I have a gynae appointment on 31st March, so not sure to take my gps advice and do permanent conti till then as scared my lining will stay thick and the advice on the sites say dont take conti only if lining is thickened
so confusing xx