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[Dotty]

Hi  I'm hoping that someone can throw some light onto my situation.  I know there are quite a few ladies who have been suffering with post menopausal bleeding recently and maybe have the same problem as me.

I started HRT in October 2017 ( 3 years after my last period).  I eventually settled on 4 pumps of Oestrogel, Utrogestan daily and Testosterone.  This suited me fine until July 2020 when I started bleeding.  I was referred to the hospital.  I had external and internal ultrasounds and a Pipelle biopsy as the endometrium was 9mm. All tests came back fine and after one more bleed the bleeding stopped.

A year later, July 2021, I had another bleed. I was referred again to the hospital.  Endometrium was 6.5mm.  Biopsy came back fine.  Consultant told me that any bleeding within the next six months was nothing to worry about.

I bled on and off a few times in the next 6 months.  So in December 2021 I went back to the hospital.. this time the endometrium was measured at 11.5mm and a polyp was found. In Jan 2022 I had a hysteroscopy; biopsy and polyp removal.  I asked the consultant what would be done about the thickened endometrium if everything came back fine....she said they were looking for cancer so if there was no cancer they wouldn't do anything.

All tests came back clear, so my question is what happens to the thickened endometrium?  Does it disappear on its own? Do I need to do something to thin it?  I am now getting bleeding again.

Any ideas?  Thank you.

[CLKD]

MayB the regime you are on isn't clearing the womb sufficiently? 

Perhaps put the product names into the search box on the Forum to see if there are threads.   Make notes ;-)

R your symptoms more or less controlled?

[Nas]

I would be inclined to agree with CLKD,  in that the progesterone isn’t sufficient to protect the endometrial lining. Utrogestan is pretty gentle and doesn’t always do its job unfortunately.

I was in a similar situation. Bled on and off whilst on utrogestan and patch. In the end, after biopsies and hysteroscopy etc, I came off the patch and went onto a 1mg  tablet. It isn’t really a high enough dose and I have bladder issues now again, despite using localized Oestrogen!

Options I think are
1.Coil
2. A different progesterone
3. Double your utrogestan

Best of luck.
It’s a tough one but to crack for sure

X

[CLKD]

   Nas.

[Sid]

Hi Dotty

I have always struggled with break through bleeding when taking Utrogestan on a continuous regime, so I had to take it sequentially (200mg vaginally for 12 days per cycle). I had a scheduled bleed each month on this regime but no break through bleeding.  However, a scan showed the lining to be 7mm and my specialist advised me to have a hysteroscopy.  She also suggested I try a continuous regime taking 200mg Utrogestan orally each day.  This did seem to stop the bleeding, but left me feeling quite lightheaded.  I have just had the hysteroscopy and the Consultant recommended a Mirena which he fitted at the same time.  It’s early days so I will have to see xx

[Dotty]

Hi Nas thanks for your help. I think your suggestions are probably right.

I’ve spoken to my GP about doubling the Utrogestan but she’s said that’s not allowed ! x

[Dotty]

Hi Sid thanks for your help.

The consultant didn’t mention having a Mirena fitted during my hysteroscopy and my GP says that taking 200mg of Utrogestan every day is not allowed, which I know is incorrect. xxx

[Nas]

Mmmm... a specialist would allow the 200 utrogestan daily I reckon. Or you could try inserting vaginally, as it gets to where it needs to be quicker.

Mirena is meant to be a good option to control bleeding. You could enquire anyway to see what the wait is like to have it done?

It’s a right old pain isn’t it? I came off the patch for the same reason and the 1mg tablet isn’t really enough oestrogen, but I hate the bleeding. I did try 200 utrogestan but it made me feel a bit weird the next day.

[sheila99]

Good suggestions from Nas. Another option may be a sequi regime if you don't mind a bleed.

[Dotty]

Thanks everyone.  Your help is much appreciated.  You've all confirmed what my thoughts were. Will have to ponder on this one and hope it sorts itself out. x

[KarineT]

Hi Dotty,

I'm sorry to hear that you're still having issues in postmeno.

I can't tell you much because I have never been on HRT but, out of curiosity,  can bleeding occur in postmeno whether the lady is on HRT or not? Why is the endometrium thickening?  Isn't it meant to stay permanently thin in postmenopause when the body is producing a lot less oestrogen?

Karine

[KarineT]

Hi again Dotty,

You've mentioned that you started taking HRT 3 years postmeno.  Does this mean your symptoms kicked in then and you were fine before?

Karine

[Dotty]

Hi Karine yes, my symptoms got a lot worse 3 years after my last period. I’d suffered previous to this but the symptoms worsened.

If bleeding occurs post menopause, then you should be seen within two weeks by a consultant….it’s a fast track case.

The endometrium shouldn’t thicken post menopause, but using hrt can cause it to thicken. x

[KarineT]

Thanks for your reply Dotty.

I hope your issues get sorted out soon.

[sheila99]

Would an email to Dr Currie help to convince your gp the higher utrogeston dose is a good option?