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[suzysunday]

Any advice please. I have been on Tibolone for 18 months and last couple of weeks I have been bleeding.  I am waiting for a hysteroscopy and as the bleeding wouldn't stop my GP said stop the tibolone.  I am worried about the effects of stopping, it's been a week now and got terrible headache today.  I've been so stressed I'm not sure if it's anxiety or hrt withdrawal. I have to wait 6 weeks for hysteroscopy as I want it under general anaesthetic.  I don't know what to do the GP has just left it at that. The bleeding stopped when I stopped the tibolone.

[Hurdity]

Hi suzysunday - so sorry on behalf of everyone on here that your post got missed. Forum is so busy that posts quickly drop off the page and most of us only get time to answer a few posts so just go to the first page when we drop by.

How are you feeling now? It's usually advised to stop any HRT slolwy so that the menopausal symptoms come back slowly ( if they are going to return). In fact my GP told me I had to stop HRT sue to post-coital spotting, and would not send me for investigation until I had done so, and to determine whether bleeding (spotting) continued. I didn't like this advice especially as I had read that there was no need to stop HRT pending investigation so I wrote to Dr Currie ( the £25 consultation) took her reply to another GP in the practice, stayed on the HRT and got the investigation (for scan then hysteroscopy/biopsy)! I didn't have a GA - as I've never had one of these and didn't want one - would have made me nervous of the investigation - as it was, I was in and out in 15-20 mins for mine and awake the whole time.

Are you still off the hRT? If you are still feeling rough then get a second opinion or do as I did, and perhaps you might be able to retstart pending your investigation - which you will still need as Tibolone can cause endometrial thickening so bleeding should be invesitgated.

Hurdity x

[Emerald2017]

Tibolone was the first hrt I tried and I was bleeding too. It is a side effect.
My gyn suggested finally a cyclical type hrt and the bleeding stopped. I didn't stop my hrt, just I changed it. I had a scan too, everything clear.

[suzysunday]

I don't feel too bad off the net after a week and half apart from sweating especially at night.  The bleeding was getting a bit worse on the Tibolone and I was getting stomach cramps and I was getting scared.  I am so anxious that I felt I would really panic with the hysteroscopy done awake but I'm still unsure.  I was booked in for a pre op at the hospital in 5 weeks but I rang to check for cancellations and got one for tomorrow which is good.  If things are ok and I went back on Tibolone and the bleeding started again won't I have to go through all this again?  Why do some people have scans and others hysteroscopy? Also how is endometrial thickening treated?

[suzysunday]

Also I feel completely exhausted since it all started.

[suzysunday]

What are the scans like as I'm having one of those as well.  It's next Monday and the hysteroscopy next Thursday and  I'm very anxious.  I have to drink pint and half of liquid an hour before.  When I was told about the scan I thought it was one where they just put gel on your stomach and looked from the outside. But seems they want to proceed around as well.  Off all hrt until this is sorted and flushing and getting atrophy symptoms back.  I am so fed up and anxious with it all. 

[Taz2]

The scans are really nothing to worry about Suzy. The worst part for me was the full bladder and hoping I didn't sneeze!

You will be given the ultrasound first while your bladder is full. You will then be asked to go and empty your bladder (relief!) and then the vaginal scan will be done. Don't expect to be given any results on the day.

Although you feel anxious this is standard procedure so try not to worry too much.

Taz x 

[suzysunday]

Thanks. So I can empty my bladder after the ultrasound before the vaginal one?

[SueLW]

The scans are absolutely fine.  Routine.  Not at all uncomfortable; outside or inside.  The worst is the full bladder.  My recent scan was in the private clinic attached to Mothercare stores and I explained that I had a bladder issue anyway (can't empty the damn thing) and that I was very uncomfortable before we began and she told me to go to the loo and pee enough to make me comfortable, which is what I did and the scan was fine.  The beauty of the private clinic scans is that you do get your results on the day and they show you the screen and explain what you are looking at when they do it.  I found it fascinating.

Rather than having a general anaestic for the hysteroscopy, can't you ask your GP for something calming, they provide such things for people who are terrified of dentists.  I need to have a tooth out and although I don't mind other dental work, I'm terrified of the removal and so will be getting something from the GP to help me relax and get through it.  If you have a general, it will take days to recover properly. 

[Taz2]

Are you on any topical oestrogen for the VA Robin?

Taz x

[suzysunday]

I am also worried like you Robin, as I have VA and been told not to use estriol cream either.  I'm booked in for GA next Thursday as I really don't think I could cope without.  I have to say my local hospital trust have been brilliant about it.  Just have to hope the results are ok.  Then I will be concerned what hrt I will be offered to manage the atrophy and enable me to have some sort of sex life in the future.

[Robin]

Keep us posted suzysunday I hope it goes ok x

[suzysunday]

I was lucky enough to ring the hospital in case of any cancellations and there was one 2 days after I rang, so it all moved fast. I had the ultra sound scan and the hysteroscopy this week.   I'm glad I had a general anaesthetic as my stress levels were sky high.  It was yesterday and I don't feel too bad today.  They did a biopsy but seemed confident (though it's early days - results in 2 weeks) that there wasn't any cancer.  They said my endometrium was thin, caused by the atrophy.  I will know more when I get the letter with my results, but the gynae seemed to say that there was some thickening, which caused the bleeding.  I assume this was due to the Tibolone, but before the procedure she said it wasn't then after she seemed to say it was.  I think it must have been because the bleeding stopped straightaway when I stopped taking the Tibolone, 3 weeks ago.

She said if the results were clear I could continue with the Tibolone, but if bleeding occurs again then I would have to go through another biopsy, which I don't want.  The gynae also said that bleeding could occur with any HRT which would always require a biopsy.  She said the vaginal atrophy and dryness would be sorted with using Estriol cream internally.  At the moment I just use it externally.  I am very confused as I don't want to risk more bleeding with any HRT.  On the other hand I have had very bad night sweats since stopping the HRT, though the gynae said these would subside and were worse because I came off it suddenly.  I am a bit suprised that she said I could continue with it if I wanted.   They also said that my oestrogen levels were very low.  In the 2 years since the atrophy was diagnosed I have had no measurement of my hormone levels.  I am wondering why this is and how has this affected things?

If I used the estriol cream alone, how would this affect my libido?  Would I go off sex altogether?  The Tibolone was really good for libido.  I will be in the hands of my GP to advise, but they are not that helpful.   I am grateful that hopefully there is no cancer, but undecided what to do.  If I go back on HRT I would be paranoid that I was bleeding again.   On the other hand, how will I cope on the cream alone? 

[suzysunday]

Also does anyone know how long the bad hot flushes will last that have returned with a vengeance since I stopped the HRT 3 weeks ago? Desperate for advice.

[suzysunday]

Well the hysteroscopy results were inconclusive and told to have another. I am reluctant but I can't have any hrt until they get a clear biopsy.  They say the scan and hysteroscopy looked like things were ok its just the inconclusive biopsy. They suggested another scan and then I MAY get estriol for local use if things look ok.
I am so anxious and have nothing for my VA.  Does anyone manage their VA on non Hrt lubricant. And if I can use estriol, does that manage the VA.
I am so depressed about it and hot flushes returned with a vengeance.  It's managing the VA that worries me most. It was under control before this.