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[Ivy]

A while since I posted. To recap, I am 13 years post menopause. I have had bleeding for the last 6+ years. Hysteroscopy then showed vey thin walls to the uterus and pinpoint bleeding all over the inside. Have had to keep increasing treatment as bleeding gets worse over time. Now on HRT which I don't want to be. Still bleeding even so. Decided to see a different gynaecologist to get a fresh view on it all. She is ordering a couple of scans and also a referral to urologist as I also have bladder problems. I saw this new gynae doctor 10 days ago. Since I saw her the bleeding has stopped for the first time in over 6 years. This is so strange I don't know what to make of it. I am having really odd ideas, like maybe a tumour has grown across my cervix so blood can't get out, maybe the chemist was giving me HRT with no estriol in it, I just don't know so keep coming up with these mad ideas. Any one got any more sensible ideas?

[Taz2]

Hi Ivy - a bit of a puzzle for you. Did you have normal periods which stopped seven years ago and then begin bleeding constantly? I just wondered how you know you have been post meno for thirteen years. How long have you been on HRT and which type? Also, what type of treatment have you been on for this over the past few years? Sorry - lots of questions!

I'm sure someone else will be along soon to help try to solve what may be happening. In the meantime try not to worry too much.

Taz x 

[Hurdity]

Hi Ivy

I don't understand either - but bleeding can also be cause by an atrophic uterus wall - ie it gets too thin and gets ulcerated and bleeds. I am not familiar with all the causes of this but one of these would be too much progestogen without oestrogen eg from a Mirena, or the mini pill - if these were continued well into post-menopause or maybe late peri-menopause. In the continued absence of oestrogen then I presume the uterus lining would stay thin.

Well it could be the reason the bleeding has stopped is because of the HRT (depending on how long you've been on it and what type) - the oestrogen may have built up the uterus walls so they are no longer atrophied.

This is just one explanation and I am not an expert, but as Taz says, try not to worry and wait until you have had the scans and bladder appointments.

Hurdity x

[Ivy]

I seem not to have made it clear. The points you are asking about were all in my post but I'll re-quote clearer.

I am 13 years post menopause.

For 7 years I had no bleeding.

For the last 6+ years I have had bleeding.

Hysteroscopy 6  years ago showed vey thin walls to the uterus and pinpoint bleeding all over the inside. ie. atrophy to uterus.

It was treated with oestrogen pessaries, but every few months had to increase the dose, due to increase in bleeding, then evenutally put on HRT.

Been on HRT for a year.

Still bleeding on HRT. It never has stopped it.

Decided to see a different gynaecologist to get a fresh view on it all.

Saw new gynae doctor 10 days ago. Since I saw her the bleeding has stopped for the first time in over 6 years of bleeding.

Why would it suddenly stop?

She didn't do anything; we just talked. It seems an odd coincidence. If not bizarre.

[Taz2]

Sorry not to have understood your post but all is now clear.

I can't imagine what it has been like to have had six years of bleeding - were you not offered a hysterectomy? I don't know why the bleeding has stopped - although it must be nice to have some relief from it. It seems that a year is quite a long time for HRT to begin to work on the lining but maybe this is what has happened? Which HRT are you on?

Taz x

[Hurdity]

Hi Ivy

Thanks for clarifying.

It does seem strange to get an atrophic uterus after 7 years. Were you taking any progesterone or did you have the Mirena coil during this time?

I also wondered what sort of oestrogen pessaries you were given because I don't know of any that would treat an atrophic uterus (although not an expert!).

Are you in UK? The only oestrogen pessaries here are Vagifem and formerly Orthogynest - but they have no appreciable effect on the endometrium, as they are very low  odse vaginal oestrogen to treat vaginal atrophy. It doesn't sound like you've had good treatment from your doctor at all - although surely a gynaecologist would have identified your uterus as atrophic and given you something stonger?

It is odd that the bleeding suddenly stopped but depending on the type of HRT it may well be that your lining has now increased sufficiently to prevent it. It must be a very low dose HRT?

Anyway the important thing is that it has stopped, and sounds like you are under the good care of a gynaecologist. What has she recommended as continuing treatment?

Hurdity x

[Ivy]

Hi Taz, Hurdity

Thanks for your replies.

I am on Kliovance at present. They tried me on the stronger one - Kliofem - but it made no difference so I went back to Kliovance. It reduces the bleeding but doesn't stop it.

Yes, it has been awful for 6 years, especially as it has got worse year by year. I was not offered a hysterectomy. I think my original Gynae doctor was incompetent (he mixed "bloating" up with "bleeding" for example).

I had vagifem, then stronger vagifem (they don't do the stronger one any more), then Orthogynest pessaries once or twice a week, then Orthogynest cream two or three times a week, then necessary every day, then not really working at all. When I started on each treatment it ws just sufficient to reduce the bleeding and then each treatment became less effective as I increased doses. I am guessing my oestrogen levels kept dropping.

I've just started with this other new Gynae. When I've had all the tests, and if they show the same as last time, I don't know what she will decide. But I like her, and she seems to be very thorough.

Apparently there is always a risk of bleeding from lack of oestrogen post- menopause as it continues to drop, so it can happen any time. Since most people don't get it, though vaginal atrophy is quite common, the uterus stuff I have seens less common. I suppose I am unlucky. I had no problems or symptoms with the menopause itself which was great, then this 7 years later.

[Ivy]

No idea what was going on, but the bleeding is now back. Had a wonderful fortnight without it. Having scans soon so hope will find out more.

Edit.

Had scans. I don't know if they found anything as the doctor said she needed to look at it all on high definition equipment, but last time I had a scan they were able to tell me about it all immediately. It may just be different doctors, or different equipment but I can't help worrying.

[Ivy]

The scans showed nothing except a fatty liver.

I've reduced my HRT, going from 2mg oestrogen to 1 mg oestrogen. The bleeding has stopped. I can only think it has taken over a year to thicken the walls of the uterus, which seems a very long time.