Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Suziemc on December 30, 2022, 11:10:17 PM
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Hi all
I'm 59 and had my last period 10 yrs ago. Back in Feb this year I started on HRT, using Oestrogel and Utrogestan. I've also used vagifem for last 10 years with occasional steroid cream (Betnovate) for vulval itching.
On Monday this week I noticed bloody discharge, so when GP opened on Weds morning I managed to get an appt for that afternoon. My GP surgery are fantastic, GP had a good chat and a quick exam and referred me to gynae, I have appt for a scan on Tues next week and a follow up telephone consultation to discuss the result on Thurs. I also have a blood test for CA-120( not sure if I've got number right on that one!) on Thurs. So NHS has come up trumps for me so far!
My question is - on reading the Oestrogel patient info leaflet it says to stop using if you get unexplained bleeding and see a gp. But my gp, who is pretty clued up on all things meno, didn't mention this. Anyone know if this is one of the out of date buts of info in the leaflet? Should I stop using the gel?
Thanks
Suzie
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Hi no you don’t need to stop using the gel.
Your doctor has done the right thing in referring you . I’ve been through this three times and there’s never been any reason found for the bleeding. It was put down to being “one of those things.”
Hope everything goes well x
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Thanks Dotty. My instinct was to trust my GP, not the info leaflet but then I started doubting myself! Good to know your bleeding was 'nothing', I'm not overly concerned as its all being dealt with so quickly but I really hope for the same outcome as you! Thanks again x
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Hello Suziemc
Many years ago I had unexplained bleeding when I increased my Evorel patch from 50mcg to 75mcg. Everything was fine but I was told to lower my patch dose and the bleeding resolved. Since then I have I used gel but again had unexplained bleeding plus painful breasts. Fortunately everything was fine but once again I was told that the HRT was causing the problem and I needed to reduce the dose.
If you are given similar advice by your GP you may want to think about how you will respond and if you are happy to reduce your dose or try another form of HRT. Forewarned is forearmed as they say!
Take care.
K.
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Hi all
I'm 59 and had my last period 10 yrs ago. Back in Feb this year I started on HRT, using Oestrogel and Utrogestan. I've also used vagifem for last 10 years with occasional steroid cream (Betnovate) for vulval itching.
On Monday this week I noticed bloody discharge, so when GP opened on Weds morning I managed to get an appt for that afternoon. My GP surgery are fantastic, GP had a good chat and a quick exam and referred me to gynae, I have appt for a scan on Tues next week and a follow up telephone consultation to discuss the result on Thurs. I also have a blood test for CA-120( not sure if I've got number right on that one!) on Thurs. So NHS has come up trumps for me so far!
My question is - on reading the Oestrogel patient info leaflet it says to stop using if you get unexplained bleeding and see a gp. But my gp, who is pretty clued up on all things meno, didn't mention this. Anyone know if this is one of the out of date buts of info in the leaflet? Should I stop using the gel?
Thanks
Suzie
I am also 59 and have been on Evorel Conti for nearly 4 years. I had a tiny very light bleed (only visible when wiping/minor spotting) on Christmas Eve. I realised that I had been slightly inconsistent with applying patches and had used Vagifem much less frequently. I decided to correct this and see if it stopped. It had stopped by the 28th. I am not going to the GP unless it returns. My practice isn't strong on HRT issues. I have had a hysterosocpy and vaginal scans before due to light bleeding and nothing has ever been found.
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You don't need to stop HRT before the scan. I was recently in similar situation, I carried on with HRT and had a scan that showed nothing. My GP mentioned that it's recommended to stop but i said i preferred not to and she agreed.
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My gp said the recommendation was to stop but left it up to me to decide. I used one pump less. Don't stop the VA treatment though.
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HI Suziemc,
I'm on the gel, and when I increased my dose to help my sleep (which it has done) I had some slight spotting for about 1 week, then it stopped. I think it was just my body getting used to the increase
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Thanks all for the advice. I did continue with my HRT. I've now had the scan (amazing nhs, same day GP appt, scan booked within a week - in fact within 3 working days - appt to discuss results two days later).
Scan showed slight thickening of womb lining and potential polyp so now waiting for hysteroscopy appt which should be within two weeks. The advice now is to stop HRT until result of biopsy is known. Superb service from everyone so far, I feel very lucky.
Suzie
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Hi I had the same as you. I didn't stop the hrt for the hysteroscopy. x
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Hi I had the same as you. I didn't stop the hrt for the hysteroscopy. x
Odd how the advice is inconsistent (but nothing surprises me!) The specialist explained to me that if the 'peripheral vessels' that the scan showed happen to be cancerous then the cancer will feed off the oestrogen. So her strong advice was to stop taking the HRT until I get the result of the biopsy and I'm happy to follow that advice as it should only be for about 3 weeks max.
Thanks for sharing your experience, it's good to hear what others have done.
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I have had similar. PMB and fast track for scan. I was 5.7 mm so over the limit for thickness. So gave me biopsy. Awaiting results. No mention of changing hrt.
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I have had similar. PMB and fast track for scan. I was 5.7 mm so over the limit for thickness. So gave me biopsy. Awaiting results. No mention of changing hrt.
Interesting! I wonder whether the inconsistencies between advice depends upon exactly what is seen in the scan. In addition to slight thickening of womb lining, 'peripheral vessels' were seen on mine which may be benign or may be cancerous- perhaps this is why I was advised to stop. I have my hysteroscopy and biopsy tomorrow so time will tell!
Out of interest, if you don't mind me asking, do you have a Mirena coil?
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I have had similar. PMB and fast track for scan. I was 5.7 mm so over the limit for thickness. So gave me biopsy. Awaiting results. No mention of changing hrt.
Interesting! I wonder whether the inconsistencies between advice depends upon exactly what is seen in the scan. In addition to slight thickening of womb lining, 'peripheral vessels' were seen on mine which may be benign or may be cancerous- perhaps this is why I was advised to stop. I have my hysteroscopy and biopsy tomorrow so time will tell!
Out of interest, if you don't mind me asking, do you have a Mirena coil?
When I had the hysteroscopy, I was told that I had to have it because my lining was over 4mm. I thought that was normal on HRT. I went through with it but the lining was actually so scanty (as the doctor described it) that there wasn't enough to even take a biopsy. I was offered the coil but said no. I had read stories of it causing bleeding and I wouldn't be able to remove it without a GA.
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No I don’t have a coil. Gel and a tablet daily.
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No I don’t have a coil. Gel and a tablet daily.
Such differences in advice....my lining is measuring at 5.3mm and I've been advised that a coil would be best way to get the progesterone required! Suspicion is that the one Utrogestan tablet daily doesn't give me enough. I have my hysteroscopy this afternoon, I've decided to give the coil a try as it can always be removed again if I don't get on with it.
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Hi would you consider taking 200mg of Utrogestan daily? Thats the advice from BMS now if bleeding is a problem.
https://www.balance-menopause.com/menopause-library/bleeding-on-hrt-with-consultant-gynaecologist-mr-osama-naji/?fbclid=IwAR0kAN0oCayLoDCbQ7lb4Ob1G0VJonG9yABwDbqIptPewC-LTKMSfp9Khtk
Also, this is an interesting podcast / article by Dr Louise Newson.
Good luck xx
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Thanks Dotty
The consultant I've just seen for my hysteroscopy gave me the option of taking 2 Utrogestan tablets, or having the coil fitted. I decided the coil was worth a try - guess only time will tell if I've made the right decision! Very interesting article, thanks for sharing.