Thanks for filling us in on the details Tinkerbell. it is really worrying how treatment differs from area to area.
What I said in my long previous post below about Vagifem still stands. I don't like to disagree with a consultant but it is shown on here that women don't always respond to Vagifem at the dose of 10 mcg twice a week - I mean as I said in earlier post - the research paper shows this!!!! Many women used 25 mcg twice a week in order to stay comfortable. As I also said some women are using 10 mcg twice a week in addition to full HRT - like myself. Your GP did not need to refer you on this basis as she (the GP) does not understand that some women need more than 10 mcg twice a week. There are women on here who have been prescribed double this amount ie using 2 x 10 mcg twice a week or as you say 5 x per week (which is the old dose).
You most certainly do not need a Mirena because you are using Vagifem!!! That is ridiculous! Endometrial thickening while using Vagifem is very unusual. Some gynaes recommend an annual progestogen challenge just to see if it has thickened - if it has there would be a small withdrawal bleed. If you want to use full HRT though, you could have a Mirena for the progestogen part of HRT and then use a patch or gel oestrogen. This should be your choice though!
You certainly don't need spinal block nor GA for hysteroscopy - if my experience (and others on here) is anything to go by.
There is no reason not to have a scan first to see if there is thickening - I mean there is no evidence of this is there ie thoikening? It's like saying I need to have a hysteroscopy because I use a medium dose oestrogen on a long cycle - which is way more than you are using.
You could find out if the female gynae does the hyseroscopy under LA or none?
From what you've said, you really really should not have to do all of this - and you need to tell your doc this or someone before it goes too far?
Rather than go to see a private gynae, could you write all of this in an e-mail consultation with Dr Currie (costs £25) and see what she says. Info on the home page of this website. Then take it from there.....
Hope this helps
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Hurdity x