Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Wenj27 on August 12, 2024, 02:29:44 PM
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Hi ladies all new here thankyou. I was looking for bit advice or reassurance. I started hrt combined continous 50 patch and 100mg utrogesten every night, after 6 weeks i started spotting and had the rage i always used to get . I was put on this as they think i am post menopause i am 54 and said i had a hormone imbalance i was angry, crying constantly anxiety ten fold, worry, overthinking, not sleeping well had no patience and very antisocial. Since all the spotting started its all creeping back quickly. I have had an ultrasound the said my lining was 8mm so going on monday to gynaecology I am terried. I had no bother with bleeding or anything else like that till i started hrt. Wish i hadn't 😩
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It is really common to get spotting on hormone therapy particularly in the first few months. It doesn't even sound as if this scan was indicated unless you have personal risk factors for endometrial hyperplasia.
It is often just a knee jerk reaction to what is virtually always a benign process.
Guidelines do recommend a biopsy if over 4 or 5mm however in reality it is rare to have atypia or malignancy if it is under 10 or 11mm.
You will probably be offered a mirena IUS which is great for getting rid of bleeding and keeping the lining thin, or alternatively either increase the dose of continuous progesterone or go on cyclical HRT for a while.
On the other hand if you genuinely regret starting hormone therapy, it is a reversible decision and you can stop it at any time if you aren't comfortable, however I would suggest fully informing yourself of the health protective benefits before deciding to come off it.
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'they think I am post menopause '
:welcomemm: who might 'they' be? When was your last monthly period?
perimenopause - those years leading up to the final bleed = menopause proper - can throw up some unusual symptoms which are confusing. Which symptom would you like to ease with a replacement regime?
R the rages cyclical, mine certainly were :o ! Every1 knew to stand well back as I lit the blue touch paper. Things that I could cope with would suddenly sent me into a fury!!!
Gynaecologists often don't know much more about menopause than many GPs seem to do, get this appt over with and see what the result reveals. Don't be scared! After that U might consider getting onto a waiting list for a dedicated menopause clinic for advice; there are clinics in both the NHS and private sectors.
Let us know how you get on.
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Its just the scare factor for the 2 week pathway. The fact i had none of this spotting before I started. Just feel hormones are out of whack. I will see on Mo day. My gp said when i spome to him that there was nothing definite to see but they have to look inside.
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'who might they be' ? :-\
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Sorry my gp i was just typing in my head lol. I do want to carry on with it i suppose but when something like this tests and stuff happen it throws me. I am a very very anxious person one of the reasons i was put on this as antidepressants and phsycologist wasn't helping. I get myself into a state and always think the worst.
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It's really common to get some bleeding in the first 3-6 months of any new conti regime. Usually they won't even send you for a scan until after this time. I think she's just being hyper cautious. You should give regime 3 months to settle. If you still have symptoms after this you can ask to increase oestrogen.
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I got the scan my lining is 8mm got gynaecology on monday fingers crossed i'm ok. Thanks ladies for replying i'm not very good at wording things or putting it across correctly xx
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I got the scan my lining is 8mm got gynaecology on monday fingers crossed i'm ok. Thanks ladies for replying i'm not very good at wording things or putting it across correctly xx
If you mean the 'who might they be' comment please take no notice, its a well known term which we all say when referring to hospital visits.
I was going to say earlier about HRT and your apprehension about taking it. I took it for five years to get me through the hot flushes stage and that's as long as I wanted to stay on it. Fast forward many years and I am not falling apart from the lack of systemic HRT but leading a healthy lifestyle is important when the ageing process starts to take effect. HRT is not for everyone, it can be a total minefield navigating around it as the many posts on here will testify.
Keep us updated, Wenj27 and good luck for Monday X
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What were your periods doing before you went on hrt? Just wondering if you're another victim of the 'everyone is meno by 54' mantra even though some don't reach meno till their early 60s. If you're still peri the bleeding, pms and thickened lining are all to be expected, it can be 16mm before a bleed and it's perfectly normal. Hrt doesn't suppress your cycle in the way a bcp does.
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Hey never had a period for ages i honestly dont know as i had huge amounts of stress. The doctor said she did wonder if i had some of my own hormones left but sent me for scan and showed 8mm i have no pain of anything els just spotting. Felt great first 6 weeks on it then kinda back to how i was when the first time it started i had that pms used to get and i feel as im spotting intermittently im always on edge xx
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Sheila I think you could be right when i was prescribed this continous hrt i was all in a tizzy desperate because of moods. I have looked back my diary and i had a slight period for 4 days in january and something tells me last september althogh nothing in diary for last year at all as this is when i was extremley stressed to the highest point. Could this be why my spotting has started again and lining was 8mm as there wasnt a proper period every month since june had spotting this week a period mood before hand erratic. Still to go for biopsy next week though x
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Hi Wenj27
Sounds like you weren't post-menopause when you started. The thing is at 54 it's not a question of we're all menopausal but apparently 80% of women are ( in the west) though of course many of us have no idea when we reach menopause, because once you start HRT you cannot be certain when your natural cycle stops! It's a good idea to have a rule of thumb like this though to ensure that those who need investigtion are not missed.
Sheila99 - I haven't heard of women in their 60's not having reached menopause - not sure if the research has been done - (though I haven't looked!) as it would need such women to have had a natural menopause and told their doctor. And as above it's important not to think a late menopause or an extremely rare very late menopause is normal even if it is, because it is at the limit of the normal distribution, and women need to go to the doc with bleeding that goes on into late 50s for example, especially if heavy, just to check all is OK. At some point a late menopause may actually become endometrial cancer so bleeding at 58 for example if it has been very sporadic, even in the absence of 12 months without bleeding, I feel should be queried, just in case. Nothing to lose! Not wanting to be alarming but wanting to make sure late (50's) (natural) bleeding is not dismissed, even though in most cases nothing will be amiss. Maybe I'm overcautious!
Sorry Wenj27 I digressed....
I'm also surprised that you were sent for a scan after only 6 weeks of continuous combined HRT. It could also be that your lining was thickened before you started the hRT because you are not yet menopausal and the 6 weeks of conti was not long enough to thin it down..
Keep us posted and all the best anyway :)
Hurdity x
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Hey maybe if i checked my diary I wouldn't be in this mess at 54 ye just think ok must be done but the stress over past couple years wouldn't of have help sheila99 I'm grateful for all your replies. Lets just hope the biopsy goes ok and with having this period its went back to normal. oso if i am still in peri and been given the combined continous HRt would that maybe have started the period regularity up again xx
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Hi Wenj
Starting the conti HRT wouldn't of itself have started your periods again - but HRT is not usually strong enough to suppress the cycle, so if you ovulated even if very late peri-menopause, this can cause bleeding. Also continuous combined HRT does take a while to work even without a natural cycle because the oestrogen works to increase the endometrium and progesterone interferes with this process. From what I've read it doesn't instantly work on the entire endoetrium so initially there are parts of the endometrium that are proliferating and others that aren't. With the right balance of progesterone and oestrogen the whole thing starts to work and the endoetrium does not thicken.
Hurdity x
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Thankyou hurdity i'l see what happen at biopsy. Hopefully the bleeding has stopped by then its been bloody spotting now this week a full period and doc took the combined continous hrt off me on tuesday.
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My lining at start was 8mm and as i said i had no bleeding till i started hrt but my diary says i had slight bleed in january for 4 days and was on nothing then. I just don't understand all this.
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Wen, for what it's worth...
It is well known that HRT causes bleeding in the first 3 months (12 weeks) you start it. And also any time a dosage is changed, there can be bleeding as a response - again within 12 weeks. **Any bleeding which occurs within 12 weeks of starting HRT or adjusting dosages should be disregarded.** This is common knowledge although it seems that some doctors haven't got the memo and are unnecessarily terrifying women and adding to NHS waiting lists unnecessarily.
It is really quite angry-making that this should still be happening.
Furthermore, there is no need to take you off HRT before anything confirms that you need this. That is another sign your doctor knows zip about HRT.
And lastly, your symptoms (Rage) returning, really suggest that you need more estrogen - not less. And probably more progesterone to help counter that, or a Mirena coil fitted.
If they offer you a Mirena coil at your biopsy appointment, you should accept it IMO. They will do it more easily than most GPs and it will immediately deal with the bleeding situation for the next 5 years (Mirenas stop all bleeding) and you will also be able to increase your estrogen dose without worrying about more bleeding. That could be the silver lining for you, in this crap situation of an unnecessary hospital appointment your silly GP has sent you on.
And - do change GP. You need someone who is better with menopause care and HRT.