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[Ju Ju]

I had an ultrasound scan today, as I have had unexplained bleeding. When I was referred I was experiencing slight spotting, but during the last week, the bleeding has become somewhat more substantial. The radiographer told me there was some thickening of the lining and that I should see my doctor at the end of the week, when the results should have got to her. I can't get an appointment with my doctor until next week as she will not be there, but decided to see someone else as I don't want to wait till then.

Has anyone else had experience of this? What is likely to happen next? I'm not panicking, but somewhat worried. I found it rather unnerving as they were so kind and concerned at the hospital!

[Dancinggirl]

I'm certainly no expert but you may just need some progesterone to help shed your lining.  I can't remember if you are on any HRT or not? If you are on HRt what are you using? Are you still peri menopausal? etc.  DG x

[Ju Ju]

I am on HRT and do use progesterone, and have a bleed after progesterone cycle, but the bleeding has occurred when it shouldn't.

[CLKD]

What ever - don't contact Dr Google 

Un-explained bleeding should be checked so your GP has gone the correct route.  Make a list of your worries to take with you?  It is probably within normal limits for the report to take a week to reach the surgery as it has to be 'read' and reported on. 

Could your own hormones have over-ridden the HRT?

[Taz2]

I had this Ju Ju when I was on HRT. Mine was thickened but because I was seen at the Women's Health Centre at John Radcliffe in Oxford my results were sent straight round to the menopause lady (can't remember her title) and she discussed with me at the time. Because mine was "uniform" i.e. no darker patches and it was less than 6cm it was decided to leave it to sort itself out. If I had been seen by my local hospital I would have had to make a doctors appointment to be given the results. It seems so unfair for us to have to wait when the results are there - although I understand the need for them to be verified by a specialist.

Taz x

[Ju Ju]

Thanks Taz. Yes, I have to wait, so I shall have to just get busy in the next few days. Hopefully, this will pan out like it did for you. I have emailed my gynaecologist, but obviously, she won't have the results of the scan.

[Hurdity]

Hi Ju Ju

Sorry to hear about this. I can't remember what HRT you are on and how long a cycle? I seem to remember you were on oestrogen only originally before starting progesterone but not sure how long for? Also not sure now how long you've been on HRT! Sorry!!!

As you are well post-meno then your body wasn't used to the oestrogen and has to acclimatise. The time without progesterone would have allowed the lining to thicken and the extent this will have happened will depend on the dose. The progesterone cycles may not have been sufficient to shed the new build up as well as what you first experienced (if I'm remembering correctly?).

Thickening is normal on cyclical HRT and gynaes don't seem to take account of this when investigating unexpected bleeding - but perhaps that's a good thing in that nothing will be missed. In a normal menstrual cycle the endometrium changes in thickness from very thin just after a period (maybe 1-4 mm) to thick at the end of the protgesterone phase before the bleed ( can be 8 - 14 mm). There is info on the web for example here: http://www.totalradiologymagazine.com/spectrum-of-endometrial-abnormalities-on-ultrasound/ .

If it has thickened a little too much then bits of it get sloughed off causing irregular bleeding and this is why it's important to invesigate. As Taz says they will check for abnormalities but as you are on HRT it is far far less of a worry. Maybe you had small fibroids that have grown in the presence of oestrogen?

Like Taz I also had thickening of around 7.4 mm or something and I had had post-intercourse spotting - but it was at the stage in my cycle when it should have been thick. They did notice an irregularity on my lining when I had a vaginal scan so I had to have a hysteroscopy and biopsy. However it was all OK there was a small fibroid, and the actual gynase who did the hysteroscopy wasn't worried about the thickenss because he took the cycle into account. Can't think why the other gyane didn't - but as I said above - always better to be investigated than not.

Whatever the outcome perhaps they will suggest a course of progesterone like norethisterone to thin it so that you can start again?

Do try not to worry at this stage and hope all will be OK.

Hurdity x

[Ju Ju]

Thanks Hurdity. As usual, you give an informed, helpful response. Of course, I can't help by being worried, but your post has helped put things into proportion. Things haven't been helped by not feeling too good, but having to go on a course and travel, coping with bowel issues and unexpected rather heavy bleeding. Still I got through it all successfully. Just left feeling drained.

I think I started HRT March/April time last year, initially with just oestrogen to see how I responded (both 1mg oral oestrogen and transdermal oestrogen 25, as I do not absorb as well as would be hoped). I responded well and the oral oestrogen was replaced kliovance, but I had breakthrough bleeding with this and constant period type discomfort, so I went back to the original combination, plus Provera for 12 days every 3rd month, which worked better, though the progesterone period left me feeling rough each time.

Following my yearly follow up with the gynaecologist, I doubled up the oestrogen to counteract continuing symptoms. Within a couple of weeks, I had slight spotting, which I reported to my GP, who thought it was due to the increased oestrogen, but referred me on for the scan, just to make sure they hadn't missed anything. In consultation with the gynaecologist I have gone back to the original prescription and delayed the start of the progesterone cycle because of the course I have been attending.

I have emailed my gynaecologist, but of course she won't have the scan results. I will see a doctor at the local surgery on Friday, to see what happens next. And today I shall obey my lovely DH and have a lazy day.

Thank you again.

[Ju Ju]

Just had a phone call from the GP I usually see, who enquired about the scan. She has referred me to see the gynaecologist at the hospital and will write to the private gynaecologist, including the results of the scan when she gets them. I feel very fortunate to have such a thorough and caring doctor.

[Ju Ju]

Just had a phone call from my gynaechologist, who had been sent a report of the scan by my GP. The thickness is 11.8mm, but nothing 'exciting' (her words!). So I feel much reassured, though I had my sensible head on! She thought I would be offered a D &C. She is sending me a prescription, plus thinking of alternatives to Provera. The oestrogen has made a big difference, but progesterone knocks me flat again, so she has suggested Merina inside the womb.

[CLKD]

What will you decide to do?