Hi Embear
![welcomemm :welcomemm:](https://www.menopausematters.co.uk/forum/Smileys/extended/welcomemm.gif)
It does sound to me like the progesterone is not sufficient to protect the lining from the extra oestrogen you are taking? You are taking much less than the licensed dose - as is typical with the Studd regime, which is 12 days x 200 mg per 4 week cycle.
However in terms of the U/S scan - it really depends when in your cycle the scan was taken as it goes through the normal process of growing and shedding so will be at its thickest towards the end of the protgesterone part and just before your bleed starts. Also will depend on how it fits with your natural cycle. Sometime Prof Srtudd prescribes even higher doses of oestrogen with the aim of suppressing ovulation in which case the bleed would usually be less - not sure if he was aiming for this in your case?
It is good to have been referred but hopefully the gynae is also a menopause specialist and will understand and interpret what's going on re your uterus lining. For example you may have fibroids or a polyp as these can cause extra bleeding.
The most important thing is that you are able to continue with HRT due to your age and especially due to osteoporosis if your bone denisty has reduced to this extent.
Depending on the outcome of your investigation, if all is well the gynae should be able to suggest a modification of your HRT to keep your lining thin but ensure you are taking enough to protect your bones - and hopefully increase bone density. You should absolutely not need to go privately for this treatment as you have a proven medical need. If your doc does not understand this and the gynae is not an HRT specialist then please do ask for a referral to a menopause clinic. However even though funds do not permit another consultation, do please contact the Studd clinic to inform them of what is happening to you on this regime because it continues to be prescribed and for women who have one-off visits as you have - it can be difficult to deal with the consequences for those for whom it is not suitable. HRT does need to be individualised - but on NHS!
There are various options - a Mirena coil will be most effective to deal with the bleeding - but not body-identical. Otherwise there are Provera tablets, or higher doses of utrogestan.
Alternatively at your age - if you tolerate the progestogens there are two birth control pills that are similar to HRT in that they contain body-identical oestrogen - same as HRT ( estradiol). QLAIRA in one such - has variable doses of oestrogen and only two tablet free days so should minimise the incidence of pms.
Hope this helps and do report back on how you get on
![Smiley :)](https://www.menopausematters.co.uk/forum/Smileys/extended/smiley.gif)
Hurdity x