Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Pqow on July 26, 2024, 09:22:09 PM
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I had a scan yesterday and dr has called today to say I’m being referred on an urgent pathway. Obviously I’m very worried.
The scan says my endometrium was 16mm with a coarse texture, areas suggestive of cysts and areas suggestive of polyps. Nothing in one ovary, couldn’t see another. No free fluid.
Ive been on HRT for two years on and off because of heavy periods. A tiny bit of gel and progesterone but because of heavy bleeding the dr replaced this with continuous protocol HRT as she said I was probably not doing any bleeding naturally and it was a withdrawal. The continuous HRT made me bleed heavily every two weeks so I requested a scan to rule out anything. I stopped HRT altogether at the end of June as I couldn’t cope with another period and work at the same time. I’ve had no menopausal symptoms since stopping (I did expect hot flushes etc)
I’m thinking my womb lining might have thickened ready to bleed but no bleeding yet. I don’t know if I’m bleeding naturally or HRT related.
Any reassurance would be good, I’m panicking a bit now about cancer. Thanks.
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Any advice? I just can’t sleep…
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Try not to worry. They refer soooo many people via this urgent pathway. It’s just protocol for a thickened lining but the vast majority of time it’s just that and nothing more. They just have to check it out.
They might offer to fit a Mirena whilst they have a look so consider that. It will thin the lining and stop all bleeding and you could restart estrogen…
If you search in the box on this forum you’ll see loads of accounts of women referred urgently due to thickened lining and it’s very rare for it to be anything serious.
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Thank you. I’m wondering whether to restart the HRT as I probably don’t have enough natural progesterone for a bleed. And if it’s thickened in a few weeks it might be better to have a bleed. Does anyone think this would be a good idea?
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What did your doctor advise? Mine told me to stop all HRT treatment until I'd had my appointment but they all give different advice and mine was for a different issue. Are you able to ask?
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If you wanted you could take progesterone to thin it down, either sequi or conti. If you don't need the oestrogen you could stay off that so you don't build it up further. Assuming you get an appointment in 2 weeks whatever you do now won't make a lot of difference.
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What did your doctor advise? Mine told me to stop all HRT treatment until I'd had my appointment but they all give different advice and mine was for a different issue. Are you able to ask?
My GP didn’t say anything about HRT and I was a bit in shock to ask. I might call on Monday.
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If you wanted you could take progesterone to thin it down, either sequi or conti. If you don't need the oestrogen you could stay off that so you don't build it up further. Assuming you get an appointment in 2 weeks whatever you do now won't make a lot of difference.
I was wondering if it might be thick because I haven’t now had a bleed for a few weeks. I just don’t know what to do and of course I can’t help thinking it’s serious.
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I also feel very oestrogen dominant, sore breasts etc. But that also might be because a bleed would be due.
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What did your doctor advise? Mine told me to stop all HRT treatment until I'd had my appointment but they all give different advice and mine was for a different issue. Are you able to ask?
My GP didn’t say anything about HRT and I was a bit in shock to ask. I might call on Monday.
Actually my doctor didnt say either. It wasn't till I requested a repeat prescription and they wouldn't do it. By then I'd about 5 days to my appointment so pretty pointless stopping
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If you wanted you could take progesterone to thin it down, either sequi or conti. If you don't need the oestrogen you could stay off that so you don't build it up further. Assuming you get an appointment in 2 weeks whatever you do now won't make a lot of difference.
I have some Utrogestan in the cupboard, I could take that.
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I would take a massive dose of progesterone to provoke a good bleed. The Utrogestan should be OK used vaginally but I would be inclined to order some norethisterine online because it's a very strong, synthetic progesterone that will strip the womb lining.
I think you will find you just need a good clear out.
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I would take a massive dose of progesterone to provoke a good bleed. The Utrogestan should be OK used vaginally but I would be inclined to order some norethisterine online because it's a very strong, synthetic progesterone that will strip the womb lining.
I think you will find you just need a good clear out.
Even with the cystic/polyp areas?
I have been bleeding every two weeks on Evorel Conti but ‘periods’ have been short 2/3 days but violent. Then stop abruptly. Dr told me it needed 6 months to settle but I stopped all HRT after about 2.5 months as it was just too much.
Thanks for your help, I am honestly going out of my mind here with worry. I do have anxiety which doesn’t help. It helps to chat to others, thank you.
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The womb lining is often between 16-18mm just before a bleed and it should go down to about 3-4mm immediately post bleed.
Evorel conti contains norethisterone so I'm surprised you have not been been shedding properly. It could be that you are producing some of your own oestrogen which is causing build up? Oral norethisterone might be worth a try and it won't do any harm.
Polyps are very common and you might need to have them removed but it could be that the womb lining build up is a separate issue. Polyps are rarely dangerous.
It's good that you have had a scan and I wonder if they may even suggest a Mirena coil? In my opinion all women should have regular transvaginal scans irrespective of HRT use.
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I would take a massive dose of progesterone to provoke a good bleed. The Utrogestan should be OK used vaginally but I would be inclined to order some norethisterine online because it's a very strong, synthetic progesterone that will strip the womb lining.
I think you will find you just need a good clear out.
Even with the cystic/polyp areas?
I have been bleeding every two weeks on Evorel Conti but ‘periods’ have been short 2/3 days but violent. Then stop abruptly. Dr told me it needed 6 months to settle but I stopped all HRT after about 2.5 months as it was just too much.
Thanks for your help, I am honestly going out of my mind here with worry. I do have anxiety which doesn’t help. It helps to chat to others, thank you.
I know exactly how you feel though it was a different problem. Your mind goes wild and the anxiety can be crippling. We jump to the worse case scenario straight away and ignore all the other possible less serious and sometimes more obvious causes. I think it is natures way of preparing us for threat and to keep us on our toes so that we check worrisome things out but it becomes a problem when its out of control. I'm sure you will be okay. The time comes around quickly and once you actually go I found I wasnt anywhere near as anxious or nervous as I had been. Personally I wouldnt do anything medication wise unless Id checked with my doctor though.
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Thank you. I do think I might be producing some of my own oestrogen, I’ve posted a thread elsewhere for advice.
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Thank you 🙏🏻
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Suggest that it is worth withholding any other treatment until you have had an assessment, which is likely to be soon. The scan findings could be a polyp, which are common and not serious. Also, the measurement very much depends on if you are still perimenopausal or postmenopausal, and what HRT regimen you were using.
I would not recommend buying hormone treatment online, including norethisterone--it can have side effects, and if used in the dose that is recommended to bring on a bleed, or stop bleeding, it is associated with an increased risk of deep vein blood clot.
It would be very unlikely that there is any serious findings, but suggest just waiting at the moment.
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Suggest that it is worth withholding any other treatment until you have had an assessment, which is likely to be soon. The scan findings could be a polyp, which are common and not serious. Also, the measurement very much depends on if you are still perimenopausal or postmenopausal, and what HRT regimen you were using.
I would not recommend buying hormone treatment online, including norethisterone--it can have side effects, and if used in the dose that is recommended to bring on a bleed, or stop bleeding, it is associated with an increased risk of deep vein blood clot.
It would be very unlikely that there is any serious findings, but suggest just waiting at the moment.
Thank you, I will do that.
The radiologist report does say could be a polyp but couldn’t confirm. As well as other areas of small cysts.
I don’t know if I’m post or peri meno, when I started HRT I definitely wasn’t post meno. 2 years later using the gel in and off (and a very small amount) and the GP wanted to stop me bleeding for iron levels so put me on EvorelConti in April which triggered a heavy bleed every two weeks.
Thank you
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Plenty of excellent advice here already.
Try not to worry. I’m one of many women here who have been investigated for peri/post menopausal bleeding on the urgent two-week pathway - twice in my case! - and everything was fine. It’s just protocol.
From this and your other post it sounds like you are still in peri and have your own natural cycle going on. 16mm isn’t abnormal if you are not yet post menopausal. And, if you do have polyps or fibroids - both benign and extremely common - these can give a false thickness reading on ultrasound (this is what happened in my case). Fibroids can be very sensitive to oestrogen and cause troublesome unscheduled bleeding, as I have experienced myself.
If you were already having heavy periods they might suggest a Mirena coil, which I’ve not had myself, but many find it extremely effective.
I hope this is reassuring. What you are experiencing is really common around menopause.
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Plenty of excellent advice here already.
Try not to worry. I’m one of many women here who have been investigated for peri/post menopausal bleeding on the urgent two-week pathway - twice in my case! - and everything was fine. It’s just protocol.
From this and your other post it sounds like you are still in peri and have your own natural cycle going on. 16mm isn’t abnormal if you are not yet post menopausal. And, if you do have polyps or fibroids - both benign and extremely common - these can give a false thickness reading on ultrasound (this is what happened in my case). Fibroids can be very sensitive to oestrogen and cause troublesome unscheduled bleeding, as I have experienced myself.
If you were already having heavy periods they might suggest a Mirena coil, which I’ve not had myself, but many find it extremely effective.
I hope this is reassuring. What you are experiencing is really common around menopause.
Thank you that’s reassuring. I have been offered a Mirena but as I have a difficult to reach cervix I declined. However if they’re rummaging about they may as well pop one in!
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Yes defo get them to put a Mirena in. Hopefully they will give a local anaesthetic at least so it should be much more comfortable to get it fitted...
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I have had lots of instances of PMB whilst on HRT. I finally decided on a Mirena to try and control it and it has been much better for me. The bleeding stopped altogether after a few weeks and my headaches have been better.
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Thanks all, I’m hoping to hear about an appt soon.
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shropshire lass, you might want to get your ferritin checked. Just - if you've had heavy bleeding for a while along with headaches, it suggests iron deficiency. You can easily fix that by taking iron supplements. Ferritin should be over 100 (don't listen to doctors telling you 30 (for eg) is fine...). There's a great Facebook group called The Iron Protocol with a guide for how to fix iron.
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Hi Joziel, My ferritin was 66 a few months ago. I had it checked because of dizziness and headaches and because I am often borderline anaemic. Drs said I was fine though. My bleeding has stopped so hopefully it will improve. I have self medicated on low dose iron in the past. Will check out the website
PQOW I do hope you've had your tests by now and that you have got some reassurance
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Hi there - Your ferritin should be over 100 and you can definitely have symptoms if it's only 66. There is a great Facebook group called 'The Iron Protocol' - don't join the UK version, join the main one because it has detailed guides telling you what to do...