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[Ljp]

Hi
After a bit of advice, I'm 3 years post meno, been on oestrogel, Mirena and estring since Dec 2015.
Tried without estring for approx 6 months but bad VA flare up, so been using this estring since early April.
Yesterday and again today, I'm having a slight bloody mark when I wipe, not enough to need a pad or anything and not all the time.
Just wondering if I need to be concerned?
I had a transvaginal scan last week as the strings from Mirena have gone up into my cervix, the sonographer said everything looked good, no concerns, ovaries fine, lining of uterus fine, just a very small less than 1cm fibroid, but nothing to be worried about.

Any ideas?

[Dancinggirl]

Quite normal to get a bit of spotting with the Mirena - not every woman will be bleed free with the mirena.
If you start to get a proper bleed then this needs to be investigated - sometimes the Mirena can fall out.
Don't worry. DG x

[Ljp]

Thanks DG, I had a little spotting a while ago, but not had anything for ages. As I couldn't feel strings I was worried Mirena had fallen out, but I did think I'd have noticed if it had.
Anyway it was there on the scan, and in the right place 😊

[Hurdity]

Did the sonographer say how thick the lining was? Sometimes you can get bleeding or spotting when it is very thin - because high doses of progestogens can cause endometrial atrophy. I presume you would have been told if this were the case? Very low oestrogen doses would be more likely to lead to this (if it was going to happen) in post-menopausal women with a Mirena coil.

Hurdity x

[Ljp]

Hi Hurdity thank you for the reply, I asked the sonographer if the lining looked ok and she said yes. So presume that meant not too thin and not too thick, I'm seeing my GP next Thursday for routine appointment to discuss the scan, so I will mention and ask her.

Couple of things to add Hurdity, how would I know if oestrogen levels were too low? I'm currently using 2.5 pumps oestrogel daily. The only thing that has 'changed' recently is I have started to use the estring again, after having a break from it for almost 6 months, as wanted to see if the oestrogel and vesicare were enough to keep bladder and VA under control, but had severe flare up in March, thought it was thrush as used to suffer terribly years ago, but swab was clear.

I must admit even almost 18months on HRT and things still confuse me.
The only other time I've had any post meno spotting was before I started HRT and was just using estriole cream. Then when I first had Mirena fitted, and a couple of days here and there when I have estring, I had no spotting at all during the 6months without estring. So I question if it's the extra oestrogen in that area that causes a bit of spotting, but only last week the sonographer said lining is fine, so I'm presuming by that it's not thick or thin, stupid me I should have asked her!

[Ljp]

Just to add, the other thing that's come back since starting the estring at the beginning if April, is tender breasts, something else I never had in the months I wasn't using the estring. All very bizarre and I wonder why?

[Bane]

It is okay to get minor spotting, not more than that or is alarming. Don't stress out, and think positive...thing will change

[Hurdity]

Hi again ljp

if you are using 2.5 pumps of oestrogel then this is at least a medium dose - assuming you absorb it well ( not everyone does). If you have no adverse menopausal symptoms then it is likely you are. It was only a thought re the thin lining - just an alternative explanation.

I can't comment on the tender breasts - theoretically the Estring should not be absorbed to any appreciable amount and especially once the vaginal area is plumped up. Also any small amount that is absorbed would be negligible when compared with the systemic oestrogen from the gel - so maybe it is the overall dose that is causing the tenderness. Equally progestogens can cause breast tenderness - although it woiuld be surprising after all this time since you had it inserted.

My breasts do become painful from time to time but then I am on a cycle (approx 7-8 weeks) so in my case it will be due to the progesterone I imagine.

I hope it settles for you anyway.

Hurdity x

[Ljp]

Thank you for the replies, it just seems strange/coincidental that this spotting and breast tenderness have returned since the reintroduction of the estring 😕🤔