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[cazjen44]

Had a review appt yesterday with my menopause specialist doctor.  I've been under her care since last Oct.  I had rang her last week prior to yesterdays appt, to tell her I had been getting mild cramping sensations and a mild pain over the area where my right ovary used to be (had both removed 2001).  She said she would perform an ultrasound scan to check my womb out, which she did yesterday.  She reported that my womb lining is 9mm and not the recommended 4mm!  With my new HRT regime - 1mg Sandrena gel, micronized Utrogestan and a very small amount of Tostran gel, I don't get periods anymore.  I always had a period with my old HRT - Prempak C and never ever had a problem or needed a womb scan, as I shed the womb lining every month.  She did say yesterday that, although the womb lining is measuring 9mm it doesn't look sinister BUT to be on the safe side she is referring me for a biopsy.  She did try and perform a biopsy yesterday, but failed as hurt to much!

My body is used to having a period and now I've had time to sleep on yesterdays events, I am questioning why I'm not on a HRT regime that still gives me a period?  Why I am freaking out so much?  She mentioned worse case scenario was to have a hysterectomy and lose my womb.  Can I just stop the progesterone part of the HRT and will my womb lining just shrink by itself?  What will happen if a biopsy shows nothing sinister but the thickness of the womb remains?  I thought if you had your womb, it was a priority to keep that healthy but now the doctor is referring me for biopsy because it shouldn't be that thick!  My head is mashed

Any advice as always greatly appreciated, although I am going to ring her I think now I've slept on it. 

History:

Surgical menopause 2001 (age 31m I'm now 48) - lost both ovaries due to endometrial cysts, still have womb
On Prempak C for 16 years up until end of 2017 when it was discontinued by manufacturer (sequential HRT which gave me a period)
GP clueless on how to manage me and find me a replacement HRT but refused to refer me to specialist menopause doctor until I complained.  8 months later, last Oct '18 I finally saw menopause specialist
New HRT regime - 1mg Sandrena gel, micronized Utrogestan, half pump every other day of Tostran gel (no period for over a year now)
I can overthink things and a bit of a nervous nelly at times!

[CLKD]

Don't over-think.  I'm sure that someone will be along.  Your Practitioner is following the usual procedure.  You may need a break but not B4 the biopsy.   How do you feel over-all?  Do you have any symptoms that the lining needs to shed?

[Hurdity]

Hi there - if you stop the progesterone part of your HRT then your womb is not protected so you do have to take it in some form or other.

The most likely reason for it thickening is simply because you are probably absorbing the oestrogen very well and the progesterone is not sufficient to keep the lining thin. The good news is that you haven't had any unscheduled bleeding which could be more of a concern - indicating (in your case) that your womb lining had probably thickened to the extent that it was shedding sporadically.

I presume you will have a hysteroscopy at the same time as the biopsy to have a look at the lining and check it looks healthy? Hopefully it is just thickened with no abnormalities.

If this is the case you could opt to go on cyclical HRT if this is what you prefer - after all you are still pretty young and many women are still having periods at your age. I was, and I am still on cyclical HRT at 65 - along with some others oin the forum! Once you are on cyclical HRT it will thicken and then be shed every month but you will need double the dose of progesterone ie 200 mg rather than 100 mg to help ensure complete clearance of womb lining.

Hope this helps and do keep us updated!

Hurdity x

[cazjen44]

Thank you for replying so promptly.

I'm definitely absorbing the oestrogen very well as feel so much better.  The cramping sensation has only started over the last 3 weeks..on and off and mild with a slight brown ish discharge. 

She performed an ultrasound scan trans vaginal one yesterday and said although thicker than guidelines recommend, the lining looked ok and not sinister.  She's still referring me to get a biopsy though..belt and braces approach..which I'm pleased about.

I've been taking new hrt regime since Oct last year, continuously but I definitely feel as though I need a period..cramps and
really bloated, feel like I'm going to burst. Bowels bit slow too.

How can I induce a period?  Before or after biopsy?  I definitely want to start having periods again as long as biopsy result ok.

Thank you again for support x

[cazjen44]

Spoke to my menopause specialist again today and she wants me to have biopsy before tweaking my hrt.  If womb healthy and just thickened then she said there's lots that can be done to reduce lining.

Just keeping fingers crossed x thanks again for advice and support x

[CLKD]

So what I suggested is confirmed, phew 

Take a pain relief tablet for the cramps