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[shrosphirelass]

Can anyone tell me is a lining of 4mm within the normal range for someone on sequi HRT?

[bloomsbury]

Hello shropshirelass,
My meno specialist insists on a womb lining of less that 5mm if you're on HRT, if that helps.
Bx

[Katejo]

Can anyone tell me is a lining of 4mm within the normal range for someone on sequi HRT?

I was told that I have to have a hysteroscopy because my lining is 5mm after 6 months on HRT (conti not Sequi and 5 years post periods).

[Hurdity]

Wow Katejo - that is only marginally above the limit - which is apparently 4.5 I think?  Are you happy to have a hysteroscopy on that basis and have you had any suspicious bleeding? Were any other abnormalities detected on the scan? shropshireless - that is indeed within the range and also quite low (excellent) depending when in your cycle the scan was done. On cyclical HRT the lining will thickne during the oestrogen phase and progesterone and then when you stop the progesterone it will be shed and immediately after the bleed it will be at its thinnest - which is when it should be measured to test if it's behaving OK on that regime.

Hurdity x

[Machair]

I have been told by a very well respected consultant this- a few years ago the decision to proceed with hysteroscopy following a scan was to be determined by a cut off point based on clinical evidence relating to the likelihood of endometrial cancer which is what everyone fears on or off HRT. Prior to this everyone had a D and C if they had random bleeding patterns, and it was just that random and not very scientific.With the advent of excellent hysteroscopy techniques and equipment procedures are really accurate and can, following scans, check up on areas and biopsy them with pinpoint accuracy. A cut off had to be established so no one fell through the net, but of course averages are just that averages. If you took 10 ladies off the street with no symptoms some might have thickened linings with no pathology.

I have a 6mm lining and am not on HRT but am being monitored. My hysteroscopy for biopsy purposes could not be completed as my lining was too atrophic - so 6mm is not always thick it may just be how I am made to be. Also scans can indicate possible pathology, but it may not be actually there when a consultant looks with a scope. Hope this helps.

[Katejo]

Wow Katejo - that is only marginally above the limit - which is apparently 4.5 I think?  Are you happy to have a hysteroscopy on that basis and have you had any suspicious bleeding? Were any other abnormalities detected on the scan? shropshireless - that is indeed within the range and also quite low (excellent) depending when in your cycle the scan was done. On cyclical HRT the lining will thickne during the oestrogen phase and progesterone and then when you stop the progesterone it will be shed and immediately after the bleed it will be at its thinnest - which is when it should be measured to test if it's behaving OK on that regime.

Hurdity x

I have had some bleeding but don't think it is suspicious.  The meno clinic consultant told me not to worry during the first 6 months. I have only been on full patches for 6 months (half ones for 3 months to start). My first bleed lasted 7 days but I had just had a cystoscopy a few days before. Since November a monthly bleed lasting 1 to 3 days. I really don't want the hysteroscopy but, when I objected, the gynae said that the only other option was to stop the Evorel patches to see if that stops the bleeding.  That doesn't seem logical to me. Better to continue the patches to see if the bleeding continues. I had no post meno bleeding b4 using Evorel and have never had heavy bleeding even pre meno.

[shrosphirelass]

Thanks all. That's good then. I think it was around mid cycle Hurdity and there were no other issues. Katejo, I have been having scans as they were monitoring a small suspicious cyst. They wanted me to have a hysteroscopy but I just couldn't do it, so dr said to have a scan in 3 months and then I had another 6 months later. They didn't comment on anything this time. Perhaps you could ask for a follow up scan, though I'm sure the hysteroscopy is more thorough.

[Katejo]

Thanks all. That's good then. I think it was around mid cycle Hurdity and there were no other issues. Katejo, I have been having scans as they were monitoring a small suspicious cyst. They wanted me to have a hysteroscopy but I just couldn't do it, so dr said to have a scan in 3 months and then I had another 6 months later. They didn't comment on anything this time. Perhaps you could ask for a follow up scan, though I'm sure the hysteroscopy is more thorough.

You say that you just couldn't have a hysteroscopy.  Do you mean that it was too painful when you tried? If so had you taken painkillers an hour or so beforehand as I have been advised to do?

[shrosphirelass]

No Katejo, I didn't even go as I couldn't face it, pathetic I know. As the cyst was tiny I thought I would take the risk and the dr was supportive and arranged for follow up scans. I find anything internal really difficult, which I am sure many do. I'm not proud of myself, but I do think sometimes they over do all the tests, but I wouldn't be saying that no doubt if there had been anything sinister.
Good luck with it x