Menopause Matters Forum

Menopause Discussion => Postmenopause => Topic started by: Alipye on September 02, 2024, 12:34:38 PM

Title: Referral to Consultant with HRT break thru bleeding…
Post by: Alipye on September 02, 2024, 12:34:38 PM
Saw a GP last week with postmenopause break thru HRtT bleeding and return of Menopause symptoms with a vengeance after 2 yrs on a revised HRT dosage. It was stressed at the start of the appt that due to bleeding and my age, I would need an “urgent” referral to Consultant to rule out Cancer and to see what is going on with lining of the womb. No adjustments to HRT until Hospital appt which could take weeks.. Today, I have found out that there is no referral to my locsl Hispital as “advice”  has been returned to the GP. Has anyone had experience of this???
I’m 55 and currently still taking Estradiol 50mcg patches with 100md Utrogestan nightly.  The menopause symptoms are off the scale at the mo- hot flushes, night sweats, anxiety, lack of sleep, body odour…. :)
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: CLKD on September 02, 2024, 01:20:05 PM
Hi.   Which Consultant were you referred to by your GP?   Unexplained bleeding is usually checked with a 'scan' to measure the lining of the womb.

Did your Surgery contact U about not being accepted for an appt.?

 :welcomemm:  browse round.  Ask away.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Alipye on September 02, 2024, 02:57:45 PM
This happened 2 yrs ago and I was referred to my local Hospital. I had a biopsy- all clear and my meds were changed from Everol sequi patches to what they are now. I have heard nothing from my GP re urgent referral being cancelled. Maybe they are waiting for my blood results to come back but I’m in the dark over this…
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Alipye on September 02, 2024, 03:00:42 PM
I’ve been really worried about having to go back and get another biopsy etc especially as the waiting times are so long and GP said it could takes weeks. I’m really confused now…
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: CLKD on September 02, 2024, 03:20:36 PM
Today, I have found out that there is no referral to my locsl Hispital as “advice”  has been returned to the GP.

How did U find out the above.  Not that I'm confused you understand .......  ;D

Occasionally when a GP refers a patient for a Consultancy the letter isn't clear enough so is returned for another referral with more info..  MayB get in touch with your Surgery ?
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Tulip on September 03, 2024, 07:43:21 AM
Insist your GP refers you for a scan. I had the same thing recently and they found some tiny fibroids, which can cause bleeding but are not a bother, and an increase in progesterone can sort those, as well as any thickening of the endometrium. But you should be checked just in case,  and they cannot refuse you. They will refer as 'urgent' because everyone is so scared about cancer, but I wasn't concerned at my GP panicking - better safe than sorry. My referral was booked in a few days. If you feel you need a check up and scan, insist on an urgent referral, but try not to worry too much, it's not uncommon to have a breakthrough bleed.
We get all the fun don't we? I'm coming back as a man!
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Chunkola on September 03, 2024, 08:15:41 AM
I had this whilst being on utro for years and then all of a sudden terrible bleeding. I switched to provera and it's been fine - actually suits me better. We decided it was a last gasp from my hormones which caused it and needed a reset to stop. I could have gone back to utrogestan but decided to stay on provera.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: bombsh3ll on September 03, 2024, 09:00:18 AM
They may have simply advised based on your low risk and fairly recent negative investigation that it might be worth increasing the progesterone for a while and seeing if it settles before rushing down the "suspected cancer" pathway.

Because bleeding is a common and almost always benign side effect of HRT the system is getting swamped with "postmenopausal bleeding" referrals, with no distinction made between those not on HRT, who have unexplained bleeding that really does need investigation, and those on combined HRT with a recognised side effect and who actually have lower risk of endometrial cancer than untreated women.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Alipye on September 03, 2024, 09:28:40 PM
I phoned my local Hosp and the Appointment service told me my urgent referral had been returned to the GP. So no Hosp appointment. After my recent GP visit, my confidence in them helping is pretty low. I understand the priory to advise about risk of endometrial “C” issues due to the bleeding but I am more disappointed that there is no help for the returning menopause symptoms.  Just get on with ur life and keep working, there are so many other women like you.  nowadays on supporting and acknowledging women esp in the workplace who suffer from Menopause but the real medical/ mental help for “all” women who suffer is woefully inadequate and disproportionate to the real stats who need help. I’m no further on but my anxiety is thru the roof. I have not heard from my GP. I’m seriously considering going private as I have to keep working each day and need help now.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: bombsh3ll on September 04, 2024, 08:26:18 PM
I'm so sorry you're not getting the care you need on the NHS.

I hate that I'm writing this but I think this is one of those situations where if it's at all possible for you, paying to see a specialist who can spend the time with you to understand your needs and has the knowledge and expertise to come up with an individualised treatment plan would be well worth it.

Nobody should be in this situation but sadly a lot are, I am on a low income and I pay privately for my pill because I can't get it on the NHS.

Life is precious and you can't really enjoy anything if you aren't well, so I'd rather save money on something less critical than my health. That's how I see it.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Kathleen on September 05, 2024, 07:47:48 AM
Hello Alipye and welcome the forum.


I am sorry that you are in this situation. Would arranging a scan privately help to move things forward with your treatment? I had an appointment with Ultrasound Direct and they were very good. They emailed all the results to me which I forwarded to my GP surgery.

I realise that you need more help than that but it would inform you about the reasons for the bleed and you can use this to prompt your GP into look again at your HRT.

Wishing you well and take care.

K.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: Wend861 on September 06, 2024, 03:52:01 PM
It would seem logical to look at your HRT medication as your menopause symptoms are so much worse. The same things don't work forever as our bodies change and you would think that would be the first thing the doctor would try. I would make an appointment, if you can, to review your medication and see if a change helps.
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: pinkmarshmallow on September 09, 2024, 07:20:58 PM
Sorry to hear you’re struggling.  I’m 55 too.   I did go private, similar problems, had 30 min appointment with gynaecologist.  He advised a pelvic scan by Ultrasound Direct.  All good.  Now awaiting blood test results but in the meantime upped Utrogestan to 200mg every day rather than 100mg to juggle hormones around again (also on Sandrena gel 2mg).  Unsure if helped on the bleeding side of things yet but think I’m having moments of ‘normal’ feelings!  Hope you get things sorted.  Update us if you can
Title: Re: Referral to Consultant with HRT break thru bleeding…
Post by: sheila99 on September 10, 2024, 05:56:41 AM
I would either try a different gp or else complain to the practice manager (though that's often a blind alley). It isn't acceptable that they leave you in this state. They could increase both your oestrogen and your utrogestan. If your hospital doesn't think a scan is necessary it isn't for your gp to withhold appropriate treatment forever.