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[hereandthere]

I’m wondering if anyone else has experienced post menopausal bleeding, as I’m stressed about going down the cancer scare path again.
Hoping it can somehow be linked to the HRT weaning?
I’d just got the good news that my surgical breast biopsy (23rd June) didn’t contain more atypical cells over the original needle biopsy finding.
Then we were straight into the Durban riots for a week. (I missed my Covid vaccination when my clinic was burnt down that week but had the first Pfizer jab the next week).
Then 12 days later (yesterday) I started bleeding- the first time in a few years.
To my astonishment I see it is actually a possible side effect of the vaccine, although not the most likely I suppose.
 I saw my gynae today and she said even though I’ve tapered right off the Femoston since my surgery (so from around 25th June I’m now down to half a tablet every second day, but started using Premarin (estrogen) vaginal cream), my uterine lining should be thinner, not thicker at 11.5mm, due to all the HRT I’ve been on. (10 she says is of concern).
I had been diagnosed as too high in circulating estrogen by my previous gynae, hence the change to Tibolone earlier in the year, but long story short I put myself back on the Femoston I still had a script for). So really only now will my estrogen be likely a bit less dominant.
So now my new gynae says I have to have a hysteroscopy to check it all out, but I opted for 25th August as I’m going on an 85 km, 5 night desert hike through the Fish River Canyon in Namibia. I’m determined this time as covid put our bucket list hike off for a year, so this is my chance.
Hot flushes all the way ain’t gonna be great though.
I’m so dreading the procedure as the doc says it’ll be under general anaesthetic! I asked about local and she said she doesn’t have the equipment and the attached hospital has a general protocol for it. For my breast biopsy I vomited twice and was really nauseous for about 5 hours and that was just at the end of June so I’m just not feeling it!
In June I had an abdominal ultrasound that showed (I think I’m remembering correctly) cysts which previous gynae said to just monitor although they could bleed. Today the new gynae said nothing about this but just pointed to the thickened wall of my uterus being a concern and because I’m at increased cancer risk I now have to undergo this procedure to check for uterine cancer.
For now I seem to have stopped bleeding early in the day, so it was about 24 hours.

[sheila99]

Try not to worry, I think cancer is the least likely outcome. Yes, the covid jab can cause bleeding, you could also have a fibroid or polyp so it's good they are investigating. When I had pre-cancerous cells I had bright red spotting between periods, nothing like your symptoms. It's right that the risk of cancer is increased if the lining is thickened but it's still very unlikely you have it. If you're still peri or using sequi hrt the thickness does vary through the month so perhaps it's thinner at other times of the month.
 Enjoy your trek. I only looked over the edge, walking it will be quite an adventure. Is the yacht club still there? Spent several weeks there before sailing my money back to the UK. Happy memories (apart from being seasick  ).

[hereandthere]

Thanks Sheila99
I’m 51, on conti as I’m past peri- at least two full years of no periods. I still get the flushes and sleeping problems though. Vasomotor wise I’m very sensitive to hormone changes, hence hot flushes since 2007, even though no discernible change in the uterus then. I must be one of the record breakers for years of hot flushes, if I’d actually ever wanted such a dubious honour!
I would have preferred the procedure before the hike, but the day before that was offered left insufficient recovery time.
I’m not clued up on Namibia and intrigued what yacht club you would be talking about. Luderitz?  The FIsh River Canyon hike runs from Hobas to Ai-Ais (which has hot springs). From which I think it takes about 5 hours to drive to the sea. The canyon itself runs 180km from Sesriem in Namibia, southward to empty into the Orange river in South Africa.
There is also a completely different GREAT Fish River in South Africa that does go to the sea, for anyone googling and thinking I’m off my tree.

[sheila99]

I doubt it will matter delaying it so you can enjoy your trek. Certainly better than trying to do the trek while you're still under the weather from the op. Flushes and insomnia would indicate you need more oestrogen so it's a bit surprising your levels are too high. They go on symptoms rather than levels in the UK so I have no idea what mine are but I believe the level you feel good on varies between individuals.
Sorry I confused you, it was yacht club at Durban marina. Namibia was another trip, unsuccessfully hitch hiking so ended up hiring a car. Fascinating country though maybe because it's so different from the UK.

[hereandthere]

I actually live in Durban, so I can tell you the yacht club is still here.
Unfortunately our Namibian trip was put off yet for another year due to two people testing positive for covid! We’d packed, so just went to the Drakensberg for a few days and weirdly I ended up walking in snow in the mountain instead of in heat in the desert.
I was in hospital on Wednesday and turned out to have a large fibroid growing in my uterine wall- not sure why this wasn’t clear as such from the ultrasound. Anyway awaiting results but from what I’ve read it sounds unlikely to be cancerous even with my history.

[sheila99]

That's a relief. Sorry your trip was cancelled but glad you enjoyed the alternative, also spectacular. There's ways next year (and without the stress by then)...

[hereandthere]

Thanks Sheila99
Sorry for the big gap but only just had the lack of cancer confirmed. I can go back on Tibolone if I want as best first systemic option per my gynae or Femoston second. Or just take vagifem or Premarin.
I’m trying to decide due to my breast risk and also the joint pain on Tibolone. My new gynae says I should have tried longer with the Tibolone previously as she says the pain could have been just the calcium moving to bone or some such and it will likely settle down. Trying to find the scientific explanation right now.

[KarineT]

Hi Hereandthere,

If you're on HRT how do you know you're postmenopausal?

Karine

[hereandthere]

Hi KarenT
I’ve had hormone tests from time to time and ultrasound regularly, which also shows the gynaecologist.  They make comments such as ‘your ovaries have shrunk as expected!’.  But besides that, initially in peri menopause I was on the sequential HRT which allows for a withdrawal bleed. Only when my gynae noted the large reduction in hormone levels (which happened quickly over a few months for me), was I switched to the combined estrogen/progesterone throughout the month. There is no withdrawal bleed. My symptoms of meno also worsened.
Finally, I’ve been off HRT since getting the ADH in my breast, but you definitely don’t have to go off it to check. (Back on vaginal estrogen cream).