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Author Topic: Post menopause spotting  (Read 571 times)

EllieJ

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Post menopause spotting
« on: January 21, 2025, 04:10:16 PM »

Hi - so me again! Apologies for going on about this. Had PM bleeding in November which led to urgent 2WW referral, ultrasound, Hysteroscopy and biopsy. Results of these were normal (thank God), but I had more spotting over New Year and it has started up again now.

I’ve just been told if I bleed again six months after my all clear Hysteroscopy, I’ll need to go back to the GP and go through it all again. Is that all we get? Shouldn’t I be having further checks to find the cause of the current bleeding? I just feel like we are pushed from pillar to post and don’t get any proper answers. The GP scared the life out of me in November saying NO pm bleeding is normal and that I needed urgent checks for cancer - now that the biopsy came back clear it’s like the bleeding suddenly doesn’t matter - well not for six months anyhow!
« Last Edit: January 21, 2025, 04:12:00 PM by EllieJ »
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bombsh3ll

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Re: Post menopause spotting
« Reply #1 on: January 21, 2025, 08:43:24 PM »

How postmenopausal are you, and are you taking HRT?

If you are on hormone therapy and sinister pathology has been excluded, the cause is simply that you have a uterus and it is responding to the presence of estrogen and progesterone in the way it is designed to do.

There is really no need for all the fear around bleeding that occurs in the setting of HRT - this is cancer in less than one percent of cases, and current clinical practice makes no distinction between this and true postmenopausal bleeding which occurs in the absence of hormones and really does warrant prompt and thorough investigation.

At this point you should be offered treatment modification to try and get you bleed free - there are lots of different options and with good medical management upwards of 90% of women can achieve complete amenorrhea whatever their age or circumstances, so do go back to your prescriber and ask to discuss alternatives.

A synthetic progestin is often far more effective in getting rid of bleeding than micronised progesterone.
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Ebonybones

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Re: Post menopause spotting
« Reply #2 on: January 21, 2025, 11:48:03 PM »

No way am I having another one
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EllieJ

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Re: Post menopause spotting
« Reply #3 on: January 22, 2025, 09:44:51 AM »

No way am I having another one
I’m with you on that!
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EllieJ

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Re: Post menopause spotting
« Reply #4 on: January 22, 2025, 09:48:29 AM »

How postmenopausal are you, and are you taking HRT?

If you are on hormone therapy and sinister pathology has been excluded, the cause is simply that you have a uterus and it is responding to the presence of estrogen and progesterone in the way it is designed to do.

There is really no need for all the fear around bleeding that occurs in the setting of HRT - this is cancer in less than one percent of cases, and current clinical practice makes no distinction between this and true postmenopausal bleeding which occurs in the absence of hormones and really does warrant prompt and thorough investigation.

At this point you should be offered treatment modification to try and get you bleed free - there are lots of different options and with good medical management upwards of 90% of women can achieve complete amenorrhea whatever their age or circumstances, so do go back to your prescriber and ask to discuss alternatives.

A synthetic progestin is often far more effective in getting rid of bleeding than micronised progesterone.

Thanks for this - my last proper period was August 2023 and yes I am on evorel conte patches. So you don’t think I need overly worry? Tbh the spotting is light and wouldn’t bother me if it wasn’t for all the fear mongering! Obviously I’m happy they are quick to act if they suspect something bad and wouldn’t want to change that, just wish the after care was better and that you weren’t left wondering if they’d missed something or what the actual cause of bleeding is! Would be great if a medical professional would just take the time to explain what you just have!
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Ebonybones

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Re: Post menopause spotting
« Reply #5 on: January 23, 2025, 09:45:50 PM »

I’ve started bleeding again my hystereoscooy was at the end of November

They removed a 1cm poly and said everything else was normal

So why I am bleeding again it’s so annoying. I did increase my Evorel patch In December so I’m hoping it’s that and will give it 6 months
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bombsh3ll

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Re: Post menopause spotting
« Reply #6 on: January 23, 2025, 10:10:47 PM »

It's just a fact unfortunately that many women do get a bit of bleeding here and there on hormone therapy.

When you were younger and your uterus saw estrogen and progesterone, it bled. It hasn't got the memo that your hormones now come in a box, it just responds as it always has.

The flat stable doses in continuous HRT are designed to keep you bleed free as best they can but it isn't perfect.

However the regimen can often be altered if this is problematic and in most cases bleeding can eventually be got rid of.

Women on continuous combined HRT especially with a synthetic progestin have a LOWER risk of endometrial cancer than those on nothing, as the progestin is very protective.

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KatyB

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Re: Post menopause spotting
« Reply #7 on: February 04, 2025, 01:38:46 PM »

Oddly enough I was at my GP today for a check on some minor spotting. She did a check, has put me down for a scan but said that they are increasingly finding that 100 mcg of utrogestan on continuous HRT isn't enough to stop some breakthrough bleeding, especially on higher doses of oestrogen (I'm on 100 patch) , so she's suggested i double up the utrogestan dose (to 200 mcg per night continuous) pending the scan. I had a 'very thin' scan a year ago though so doubting that there's much build up as yet. She was reassuring but firm that I follow up even minor bleeding She's also keen to reduce the patch size....but will wait on the scan before confirming that.
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