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[anais]

My consultant increased my Estrogel to 4x daily to control night sweats. I need to be on a minimum of 3x for osteoporosis. I also have a Mirena as 100g Utrogestan daily couldn't control the breakthrough bleeding.

The Mirena seemed to be doing its job — that is, no bleeding — on the increased dosage of Estrogel until about 3 weeks ago when I had an episode of bleeding. So I rang the hospital and I had a TVUS scan today. My lining was 8.2mm, which is significantly higher than the 3.9mm of last year, so they did a pipette biopsy there and then. The doctor who did my scan called my consultant who was in the clinic at that time for an opinion and he said to add 100mg Utrogestan daily with the Mirena in place — it makes sense in that it should stop the lining getting thicker.

I should receive the results of the pipettes biopsy in the post, but in the copy of the letter to the GP, the Dr who took the sample wrote that the specimen quality was “poor”. So that was a bit of a disappointment considering how uncomfortable the procedure was. Obviously it's better to have it done than not.

I don't know whether to be concerned or not. Obviously the thicker lining is explained by HRT, and I've read plenty of accounts of women having a thicker lining and being told they're fine after having it checked out. I've always hated the Mirena, though. The only reason it's in is because I can face going through the removal.

[jillydoll]

Hi anais.
Can't help but just wanted to say I'm sure someone will post soon.
Just wanted to bump your post up...
Xx

[Hurdity]

Hi anais - how long have you had the Mirena in? If you are post-menopausal then it should be effective in protecting the womb lining but seems maybe the increase in oestrogen has stimulated the lining despite the Mirena. If it's due to be changed can you have another one fitted - or are you OK with having the utrogestan as well?

As long as it's checked out and there are no issues then no need to worry but obviously it should not continue to increase as this can lead to endometrial hyperplasia and potentially womb cancer so you want to avoid that, and take the extra prog if this is what is needed.

Hurdity x

[anais]

Thanks Hurdity and jilly.

I've had the Mirena for 2 years and 9 months now, so it's still within its “Use by” date. There was no recommendation to change it when I saw the gynaecologists last week — the one who did the scan, who asked my own consultant for his opinion. He did previously mention that if I had any bleeding with the Mirena in place that he would recommend taking a 100mg Utrogestan tablet in addition to the Mirena. It was either that or 200mg Utrogestan without the Mirena because 100mg wasn't enough to stop the breakthrough bleeding.

So, I've been on the Utrogestan since Monday. I haven't heard anything about the biopsy results. Actually it's “pipelle” and not pipette but that's what it said on the letter the Dr wrote for me to take to the GP. She also wrote that the sample quality was “poor” — it was a lot of agony just to get a tiny bit of endometrium, it seems, so there is the possibility that the sample was inadequate for testing.

I was quite fortunate that my consultant was available on the day to look at my scan and he was able to recommend starting the Utrogestan straight away, but yes, it is worrying, although I suppose there is a cause-and-effect explanation.