Hi Stormcloud
Sorry to hear about your bleeding and problems with HRT.
So age 45 was the last date of your last natural period ie no HRT or contraception for 12 months and no period? One explanation for your increased endometrial thickness is that perhaps you were not post-menopausal yet? Sometimes with premature menopause (OK yours wasn't premature but quite a bit younger than the average) I understand that ovarian activity can resume spontaneously so could this be an explanation? I think only a particular scan of your ovaries could determine this I think, and possibly another hormone called AmH which isn't used much yet for this purpose? See here for explanation/diagnosis of menopause:
https://www.menopausematters.co.uk/diagnose.php . If periods become more regular/heavy then sometimes the progestogen in the coil is not sufficient to stop periods in which case the endometrium would grow and diminish along with your hormonal cycle.
Have you ever had fibroids or endometriuosis? These conditions could cause bleeding even with a Mriena although perhaps not uniform increased thickness (not with fibroids anyway but maybe endometriosis - I don't know enough about this?).
You mentioned you are quite overweight. I'm not sure what "quite" means but I'm sure you aware that people who carry excess weight do have a higher risk of cancer overall so this would be a good place to start trying to help yourself towards better health as you get older, if you can? I'm sure you know this and it can be quite a daunting taks although now more than ever I think there is help available. Start with your doctor and take it from there, slowly a little bit at a time....
Fat cells do increase the amount of oestrogen in the body even in post-menopausal women. Particular compounds are metabolised (changed) to estrone which converts to estradiol in the body which can have an effect on the uterus even without HRT and even when post-menopausal - although not always.
I hope that as a result of the scan and report to your doctor they recommend further investigation - if only to put your mind at rest. Even if your womb lining has thickened - the fact you have a Mirena there will have stopped it thickening too much. The key thing though is, if you didn't have a scan before, then to ask for a hysteroscopy and a biopsy just to check all is well and hopefully the doc will recommend this?
Please try not to worry - mostly abnormal bleeding is just a warning sign that something is not quite right, and usually there is a simple explanation and/or treatment without any sinister changes.
I hope this doesn't sound too garbled and will help you understand what the next steps might be perhaps?
All the best and let us know what transpires?
Hurdity x
