Menopause Matters Forum
Menopause Discussion => Postmenopause => Topic started by: Alli8 on March 09, 2025, 11:07:37 AM
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Hi Ladies,
I'm trying not to panic... I'm trying not to Google...
I was diagnosed with menopause back in July 2022 after a long to and fro with my doctor's surgery who first diagnosed depression. I was 51 at the time and on Cerelle (mini-pill) so I had no idea about periods as I hadn't had one since 2016! It probably didn't help that I never managed to see the same doctor twice. It took a few blood tests for them to finally say I was post-menopausal and prescribe HRT.
Basically, everything 'downstairs' has been fine until about 6 weeks ago when I started spotting brown discharge and getting those familiar period-pains again. I left it a couple of weeks to see if it would sort itself out but it just got worse and I contacted the doctor. They asked me to pick up a couple of swabs and gave me an appointment for the 19th March to discuss results (this was on the 20th of Feb!). I've since found out the swabs were to test for Chlamidya and Gonorrhea. If they'd just asked I could have told them there was zero chance of either of those!
In the meantime, I did what everyone tells you not to and started Googling (yes, you can roll your eyes). The NHS site states that any post-menopausal bleeding should be considered abnormal and needs checking on a 2 week referral. I went back to my doctor (we have to do EVERYTHING on a e-consult form) and wrote this, saying I wasn't happy I was having to wait. Lo and behold, I got a phone call and an appointment the next day. There was no examination, just a detailed history taking and he referred me straight away. He asked me to stop HRT for the time being, which I did.
I now have an appointment on the 17th March at the hospital - I don't like that the clinic is 'Urgent Suspected Cancer - Gynae' - you'd think they would give it a less than terrifying name.
What should I expect from this appointment? I really don't want to start Googling as I'm already fretting so thought it best to get some actual advice!
Thanks ladies.
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U really would think that they would discharge that notification for what is the recommended 2-week fast pathway to a scan etc.!
It's usual practice to check the womb lining if there is unexplained/unexpected bleeding.
It may also be the start of vagina atrophy- do read the threads on the Forum: there are several ::). 4warned is 4armed.
And do stop GOOGLING - go through NHS sites not any others ;-)
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Hi which HRT are you using ? Are you still using the mini pill?
There's no need to stop the HRT whilst you wait for an appointment.
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Hi Alli8, please try not to worry (easier said than done I know....I've been where you are).
I was referred under the 2 week urgent referral. My first step was abdominal ultrasound and tvs(Internal ultrasound)
When my lining was found to be thick at 8mm I was then sent for a pipelle biopsy but they were unable to do this due to my cervix being closed.(something like that)
I was then referred for hysteroscopy and biopsy.....which I chose to do under a general anaesthetic (as advised by the ladies on here and due to the fact I'd had a hysterscopy several years earlier and found it extremely painful....some of us ladies find it painful and some don't)....it is entirely your choice and please remember it is a choice and you can ask to have a GA if you want....this probably will mean you have to wait a while longer until an anaesthetist is available.
I too stopped all HRT....again this was my personal choice but I've never used it since.
After all the waiting I was eventually given the all clear and nothing to worry about.
There are plenty of lovely ladies on MM have been through this and have lots of knowledgeable advice and are always here.
Good luck with everything and let us know how your appointment goes on the 17th🤗
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Your doctor clearly needs some up to date education on menopause!
And please don't worry, what you are describing with the period like cramps sounds very hormonal and not at all sinister.
It does need a scan, just to be on the safe side, and a sample of the uterine lining if there is any thickening, but is almost never cancer when someone is on HRT.
And you absolutely don't need to stop your treatment in the meantime.
Just to warn you if you have abruptly stopped HRT, this is likely to precipitate withdrawal bleeding. This is not a cause for concern, it is to be expected.
The fact is that bleeding is common on hormone therapy, but the medical system is not smart enough to distinguish between bleeding on HRT and true postmenopausal bleeding in someone not on hormone therapy, hence the inappropriate use of "urgent suspected cancer" referrals for women with a benign history and no risk factors.
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bombsh3ll can I ask does reducing oestrogen cause bleeding? I had dropped from 2.75 pumps of oestrogel to 2 pumps when I had my mega bleed!
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Any change in Hrt can cause bleeding.
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It could do - when we have menstrual cycles, bleeding starts when estrogen drops.
Also when women take birth control pills, if they take the dummy pills or have a 7 day break, they bleed.
So yes lowering your dose could have triggered this, but I still think getting a scan for peace of mind is a good idea. I just don't think you need to worry about cancer.
Also what about your progestogen, what are you using and has there been any inconsistency in taking this?
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Thank you ladies for your advice. I see a few have commented that you don't need to stop HRT but I have as that's what my doctor asked me to do. He said the clinic will let me know if it's ok to re-start. I suppose it will be worth waiting to see if flushes etc come back?
The bleeding has slowed and is much lighter in colour. Whether that is due to coming off the HRT or that after 6 weeks there's nothing left to come out, I do not know.
In reply to questions regarding type of HRT... I am on Evorel 50 patch with 100mg Utrogestan daily. I stopped Cerelle not long after starting HRT.
I'm glad to hear reassurance and I'll update after my appointment on Monday.
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Good luck for your scan and do let us know how you get on!
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Perhaps the mistake is that they think you're menopausal. You may be but at your age there's a fair chance you aren't. In which case everything is perfectly normal and nothing to worry about.
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Hi Alli8
Just to say please don’t worry. The ‘suspected cancer’ wording is not ideal but it’s what they have to do to get you seen, otherwise you would be waiting for months on end.
I’ve been through this process recently, had an ultrasound and an internal ultrasound initially which showed thickening of the lining. A biopsy was taken at a separate appointment and I was then booked in for a Hysteroscopy which I requested was done under a GA. During the Hysteroscopy two polyps were removed. All painless and straightforward. I wasn’t advised to stop my hrt whilst investigations were happening but it seems that some doctors advise it but others not!
Almost all of the time there is no sinister reason for the bleeding. Good luck with your scan and let us know how you get on 💕
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Hi Ladies
I’m 5 years since last period. Had no issues until now. Not on HRT. A couple of weeks ago my boobs became so painful and I was so sad and emotional . Then I had a a lot of clear watery mucus and the following day I had a bleed . I went to drs who examined my cervix which appeared fine but has got me on the fast track for a gynaecologist. Since I saw the dr my flow has been daily but only when I have a wee and sometimes it is light but today it’s been more watery blood. Like many of us just worried sick and I do suffer with anxiety too so this has set me off . Would it be hormones that would cause this after all these years. I have been suffering extreme emotional stress for the 12 months and wondered if this can still affect our hormones after the menopause . Anyone else had this ?
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It is right that you get checked out as postmenopausal bleeding that occurs without hormone replacement really does warrant investigation, however even then the majority of cases turn out to be completely benign.
Also your age and type of menopause can have a bearing on whether some spontaneous ovarian activity may have resumed - for example if you had an early menopause or your ovaries had stopped working due to chemotherapy etc, some function can potentially come back, however if you had natural menopause at the usual age, this is unlikely 5 years on.
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Alli8 - Good luck with your appointment on Monday. Post meno bleeding always triggers the suspected cancer pathway but HRT does cause bleeding and my consultant said the risk is very low.
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Smileysteph53 - I agree with bombsh3ll you should get checked out for peace of mind. All ladies are sent on the 2 week pathway. It's very unlikely to be anything. My friend who was not on HRT had this bleeding in her 60's and it turned out to be a polyp. I do think stress can change the hormones. I had a bereavement recently and that's when I had a heavy bleed. Good luck with your appointment!
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Hi Ladies,
So I had my appointment this morning. The doctor took a brief history then had a look with a speculum (hate those things) and said everything looked healthy but I still need an internal scan to check the womb lining thickness which has been booked for this Sunday.
He queried when I had my last smear which was when I was 49 and was surprised I haven't been called for another yet. I checked the NHS site when I got home and it says ages 50 to 64 is every 5 years so as I am only 54 this year I don't expect it'll be until next year. Strange that he queried it as my smears have always been clear.
I do think a lot of these things are down to the record keeping - my sister has had a total hysterectomy and despite informing the clinic, keeps getting invited for a smear. She is getting so fed up of it she says she might just go as it would be worth it just to see the look on their faces when they get down there ;D
So I have to wait until Sunday to either panic or breathe a sigh of relief... I'll keep you updated xx
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Agree with what the others have said theres a better chance of bleeding whilst on HRT as per not post meno and this is usually always lumped in the urgent category. It can sometimes be caused by polyps as well so best to get a scan then you can stop worrying, but I have found any dipping down in my dose of HRT causes a bleed so this is more than likely what has happened in your case.
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Hello I had my ultra sound scan and then the Transvaginal one. She couldn’t see my left ovary as she said I had gas. I asked if my ovaries looked ok on the ultra sound scan she said yes but I don’t ask for any more info . Then on Friday had a call from hospital for me to have a hysteroscopy on Tuesday. This has panicked me would this be a normal route to check why I did have a bleed?
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Hi yes, i too had a scan and am waiting for a hystoscopy, it is normal if you have bleeding to have both
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Hi yes, i too had a scan and am waiting for a hystoscopy, it is normal if you have bleeding to have both
Hello I had my ultra sound scan and then the Transvaginal one. She couldn’t see my left ovary as she said I had gas. I asked if my ovaries looked ok on the ultra sound scan she said yes but I don’t ask for any more info . Then on Friday had a call from hospital for me to have a hysteroscopy on Tuesday. This has panicked me would this be a normal route to check why I did have a bleed?
Hi yes, i too had a scan and am waiting for a hystoscopy, it is normal if you have bleeding to have both
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Thank you . Such a worrying time. Hope it all goes well with you
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Is something up? So January I had Hysteroscopy for post menopausal bleeding, I’m 56 and 2 years in to menopause. Not on HRT. All looked fine, took a biopsy as was in there! Had cervical polyp which was removed and fine. no more bleeding since, biopsy came back as inconclusive. Got a letter to say happy with results and nothing furher needed. Then last week I get a phone call to say lab has requested another biopsy as there are cell changes :-\ . What does this mean, I was so taken back I didn’t ask. I have not been put on two week fast track so think that is it’s not urgent. Anyone else had something similar, I’m a bit concerned now. Thank you
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Hello an update from me. I had my hysteroscopy today . It went well wasn’t very painful at all thankfully 🙏. My bleed appears to be hormonal but they found 2 polyps which consultant removed and said she thought they were benign in appearance and not to worry . They will be sent for biopsy though. Feeling like I can sleep tonight . Have not had so much worry like that over my health before. Thanks for this site it’s a great forum to discuss our worries . Menopause is not good for our nerves that’s for sure.
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Glad it went well for you Smileysteph 53 were you awake or did you have some form of sedation when they removed the polyps?
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Hi Ladies, an update...
I eventually went for my scan last Friday after the hospital cancelling the 23rd and rescheduling for the 27th and then calling again to cancel! They offered me the 9th of April to which I told them that wasn't acceptable and where could I get it done sooner. Luckily, they found me an appointment for the next day at another hospital so that was a relief.
They rang yesterday to advise the consultant had said my endometrial lining was 4.6mm but otherwise unremarkable but would like to book a hysteroscopy and biopsy. After reading the advice from other ladies, I asked for a GA rather than the LA they were offering. They wanted to know why and I explained that I find having a smear uncomfortable and have been told (by nurses and not my husband trying to justify things) that I'm small down there ;D
Also, I've never given birth vaginally, probably for much the same reason as when I had my son I had to have an emergency C-section because I literally couldn't dilate enough for his head and he got into distress :(
So, I have pre-assessment tomorrow and the procedure on Tuesday - fingers crossed for a good result.
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How are you Alli8. X
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Thank you for your concern, I'm a bit uncomfortable but none the worse for wear after Tuesday's hysteroscopy. The worst bit was coming out of the general anaesthetic as I 'slow to respond' and had chest pains and the shakes. Apparantley it's fairly common but did rather freak my husband out :-\ Everything went well, I understand.
My discharge papers say 'Hysteroscopy uneventful, endometrium looked hyperemic, no polyps. Pipelle biopsy taken.'
The only thing I was a little wary of was when I saw the surgeon beforehand, he was really pushing for me to have a Mirena fitted during the procedure. He said it's because it's the treatment for much of these conditions. My doctor mentioned the coil years ago before I went on the mini-pill but due to my sister having nothing but trouble when she had one, it put me off. I ended up saying I'd rather wait for the results and do a bit of research. He still said 'If you change your mind just let the team know when you get into theatre'.
Was I right to stick to my guns? I know if I do need one fitted it's another unpleasant procedure but surely it's best to find out what's going on first and whether I even want to go back on HRT??
I stopped my HRT cold turkey on March 4th, on my doctor's advice. So far, I'm having a few hot flushes but it's bearable. The main reason I started taking it was the mood swings and complete lack of libido - I was HORRIBLE and if my husband hadn't been the saint he was I'd probably be divorced. So far, my mood seems ok (my husband is primed to let me know otherwise). If it stays like this (fingers crossed), I don't feel I will need to go back on it. I realised the other day that apart from when I was pregnant, I have been on some form of hormonal control since I was 16 and maybe it's time to give my poor body a break!
It's a nervous wait now for the results - the nurse said it could be 6 weeks :(
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I’m glad you’re ok. My friend had a coil but it didn’t agree with her, so I think it depends on the person.
I only went on hrt due to not sleeping, brain fog and a right ankle pain. It didn’t help with the first 2 so im hoping I don’t get any additional issues but if it is excess oestrogen that has caused this I’d rather be off it.
6 weeks is a long time to wait. This 2 week pathway is bad enough. Good luck x
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Thanks Twin, I agree with the 6 week wait being a bit daunting, especially as they rush you through the system on the super-scary 'suspected cancer' pathway.
I suspect my issue may be that ever since I hit menopause I have gained around three stone and, as we know, fat produces oestrogen. It's probably why the surgeon suggested the Mirena as yes, it's probably the easiest fix but it's just a sticking plaster and surely it would be better in the long term to shift the weight. Less fat = less oestrogen.
I am aware I am self-diagnosing; it might not be my issue at all but it seems the most likely at this moment in time.
I was never a slim body, always a pear shape but I've never been as heavy in my life as I am now and it's all in the wrong place. It's crept on steadily over 3 years and simply will not budge. I have an active job and every morning I get up early and do 4km of brisk walking on the treadmill. I have eaten low carb for the last 20+ years and it's always suited me fine until now. I'm short and according to my pre-assessment last week, have lost an inch in height which just makes my BMI worse :'(
I'll stop with the ranting and googling now and wait for the results!
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I’ve always been slim, except in lockdown when I ate like a pig and drank like a pirate 🙈. It it took a couple of years to lose the excess. I’ve got the my fitness pal app, it’s free. You don’t realise what you’re eating. I am on a low calorie regime but if I go over it i put weight on. Tbh exercise doesn’t really help but it’s good for health and mental health.
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Hi Ladies,
So finally I got my results and it's good news, nothing serious. The only question I had was my discharge notice said 'no polyps' and my results said 'polyps'. I asked my doctor which was correct and he said he thinks it should be 'no polyps'. Go figure.
I still don't know what the cause of bleeding was but I haven't had any more, thankfully.
I've been off the HRT since March 4th and the doc said I could re-start but I think I may try to battle through. He advised I take calcium and Vit D if I stay off it so that's what I'm doing. When I first started in July 2022 (aged 51) I was experiencing irritability, mood swings, brain fog, flushes and night sweats but so far, three months without HRT the only symptom seems to be the flushes.
I'm thinking if I can battle through, is it better health-wise? I don't know my family history (adopted) so am unaware of increased risks, plus I have suffered with the dreaded weight gain and have a bmi of 36-ish which is a risk in itself. The weight gain has been since I started the HRT - whether it's to blame or the menopause itself I do not know. Most of the NHS stuff says to stay on for 2-5 years. I am hoping I've been on it long enough to benefit my bones and heart but I can't seem to find any clear guidance on this.
Any thoughts ladies?
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I'm in the same situation. Not sure whether I should continue HRT or not as I bleed so much on it. It is an individual thing and it would be helpful if you could discuss with a knowledgeable consultant about what is best for you with your health and history. My gynaecologist said I was too young to come off HRT (55). It seems it's best started in the ten year window of opportunity which sounds like you. But I do believe you can be healthy and post menopausal without HRT but it needs adjustments in lifestyle. I have many friends in their 60s and 70s who never took it and look and feel great. If it helps you could read this:
https://www.womens-health-concern.org/wp-content/uploads/2022/12/11-WHC-FACTSHEET-HRT-BenefitsRisks-NOV2022-B.pdf
x
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That's very helpful, thank you. I have already developed osteoarthritis in my hands so whether HRT will be of benefit I don't know.
I would love relief from the hot flushes and to sleep better. I must admit the thought of certain areas drying up does worry me but so too does the weight I have gained. While on HRT I have been unable to shift any weight at all but since stopping I have managed to shift a couple of kilos.
I have my yearly health check in a few weeks so I will discuss things with the nurse and see what she says.
Xx