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[applejack]

Firstly, everything was clear - yay!

However, she said the results show that the recurring polyps are being caused by external oestrogen (ie hrt) and for as long as I take hrt this is likely to keep happening. I can either stop hrt, or keep having bleeding every 3/4 months resulting in polypectomies - which is not really ideal.

My body doesn't easily absorb oestrogen so not sure how much I can reduce (if I stop altogether I have no quality of life).

I am seeing my meno specialist on friday and we were going to try testosterone as a next step. Can you take testosterone on it's own (ie without oestrogen?) because if it reduces some of my symptoms is it possible to just rely on that? I've also heard that it can boost oestrogen levels so is it possible that could lead to me being able to cut right down on the patches?

I was also going to suggest going on a sequi regime to get a regular bleed but at my age (57, 5 years post meno) she might not be keen on that.

Has anyone been in this position before? It really would be dreadful if I had to stop hrt but I'm not sure having surgery every 6 months is a great prospect!

[Cazikins]

Hi applejack,
I am sort of in a similar position as you. I'm nearly 65, take Femoston conti low dose, had a hysteroscopy 18 months ago (polyp removed). Back then it was suggested to me by the female consultant that if this happened again I should seriously consider a hysterectomy (this wasn't my 1st hysteroscopy it's abpout 3 or 4 now).

Anyway 4 weeks ago I get post menopausal bleeding again, doc does a 2 week referral, lovely male gynae looks & says yep polyp, so I'm booked in for another hysteroscopy a week on Friday - now this guy has suggested having a mirena coil fitted at the same time as this will give me progesterone but to stop my HRT. He said that having a hysterectomy was much to evasive & they usually do this on woman in their 70's 

I just don't know what to make of his suggestion.

Not sure I can really answer your query about sequi regime but sometimes we have to go by what your specialist & GP come up with.

Hope you get some answers.

[joziel]

I think, if you feel you need estrogen for quality of life, then considering a hysterectomy might one idea. There are women who've had hysterectomies due to progesterone intolerance - so they can just have the estrogen in HRT. Hysterectomies can often be done just with laparoscopic surgery these days...

Otherwise I'm not sure about just having testosterone. It would be better than having no hormones at all, but there are many health benefits relating to estrogen which don't relate to testosterone - that's why men have higher rates of cardiovascular disease.   

I'm sorry, it's a difficult one. By the way, what is wrong with leaving a polyp there and monitoring it, like a fibroid? Is it that it could grow into something more concerning?

There is the option of just continuing to have them removed? They can tell you that you will keep needing it, but perhaps you won't after a while...? They won't like that option because it's going to take more time and resources and they can't just treat you and be done, but if you think it's best for your health as the option to take then it should be your choice to make.

[QueenofReds3]

Hi applejack
I am pleased that you had the all clear. I am frustrated though as you know I too have had hysteroscopies x 3 and had polyps removed. But each time I ask I am told it is NOT the HRT causing the polyps but the post menopausal bleeding is how they found out I had them. Polyps are not a worry but if left for a long time can become cancerous is what I was told but I am starting to lose faith in GPS and gynae at the moment. I was told fibroids are caused by oestrogen feeding them but as we go into post menopause they should not occur as much. The build up of the lining of my womb is down to the HRT like Cazikins I was offered the mirena coil. I declined this time so I am waiting for provera to be prescribed. If this does not work I think I will stop HRT all together as I have been on tablets, patches for the last 3 years and honestly can say I don’t feel great especially in the last year. I don’t know much about testosterone, GP do not prescribe it here. I am on NHS menopause clinic waiting list though a year wait!
 I agree with not wanting surgery every 6 months though, it’s a tough one.
I feel we are left to sort it all out ourselves, my GP is clueless, in-fact he said at my last call, that I could do or have what I want! I would like not to have bleeds, polyps, symptoms, hysteroscopies please.

[applejack]

Cazikins - same here.  Both the gynae who did the hysteroscopy and the meno specialist both said a hysterectomy really is a last result and they didn't recommend it.  Mirena is what they've all recommended and I did have one fitted in November which we hoped would solve everything, but it didn't.

Joziel - for this polyp they did start monitoring it. We tried a coild and when the bleeding started this time she said ok, let's add norethisterone and see what happens.  The polyp doubled in size! Her reason for taking this one out was - the fact that it was growing so fast yes, but she didn't want to risk it becoming pre cancerous. Which is fair enough. She did say I could just keep having them removed but the thing is, before we reach that point there's bleeding, cramping and the hassle of scans, hospital visits etc which seems to be happening every 4-6 months. It's so disruptive.

QoR I was also offered provera, not sure why they went for norethisterone but I doubt it makes much difference.  Either way, it didn't work. My GP was pretty much like yours - telling me it was up to me to decide what to do without really suggesting what the options were. I got private cover from my partner's firm since then and it's made a world of difference. As far as I've been told, you can have polyps without taking hrt, and they're more common post meno. I don't know how they worked out that mine were hrt triggered but she was absolutely sure from the results that they were.  Apparantly they can test for that.

I'll update when I see the meno specialist - sounds like a few of us are in the same boat so it might be worth sharing the information when I get it.

[joziel]

applejack, it sounds really difficult

How many times has this happened now? x

[applejack]

In the past year I've had two hysteroscopies under GA, and also a ghastly pipelle biopsy/polyp removed with no pain relief which I never want to go through again. So that's three polyps in 12 months. I'm like a polyp magnet.

[QueenofReds3]

applejack, I totally sympathise with you on the biopsy, polyp removed. On all 3 of my hysteroscopies removing them I have never been offered GA or Local, the first 2 were bearable but the last one has left me scarred mentally, the pain was excruciating and I was still cramping bleeding ten days on. Well I have now got my provera and gel prescription, but no instructions on how to take the provera, do I take one daily continuously? With or without food and what time is best. The instructions do not say.

[applejack]

Oh you poor thing, no wonder you were traumatised.  The biopsy I had without GA took the longest to recover from - quelle surprise.

Well that's completely rubbish - I guess you can't even ask the pharmacist as I assume they simply put the docs instructions on the sticker. 

[applejack]

Well, my meno specialist raised the issue of hysterectomy today and suggested it may well be the only solution. Yes, it's major surgery but if I'm having polypectomies every x months then it becomes a case of - when does this become unsustainable?  Or I stop taking hrt, of course, which hasn't been successful for the past 12 months anyway.

In the meantime we're going to give testosterone a whirl and see how it goes for the brain fog and libido.

[QueenofReds3]

Good luck with the testosterone applejack. It is a major surgery but quality of life is important. I am braving starting the provera tonight. If this does not work or I get more a bleed down to another polyp I am stopping HRT. I am hoping though that I get to see a NHS specialist soon who knows what they are talking about. Up to today I have had a ten day break off the patches which GP told me to stop as like you was not helping with symptoms anyway. I have to say that apart from wanting to go wee all the time I felt clearer in my head then before but I know if I left it too long all the other symptoms may return. But when do you know when to stop, I knows  some do blood tests. My GP does not do them so I had one done privately, it said I was in the right range for post menopause.
I have noticed since starting coming on to menopause matters forum that there is a increase in women desperate for help and answers. I work in a GP and they have been quite good even in lockdown seeing patients but my own is terrible they have weeks waiting list even for a call.
We are left to work this whole thing out ourselves in the end. I hope your specialist is supportive and you find the right path whichever route you go down. X

[AKatieD]

I am waiting for my crazy "menopause specialist" gp to say the polyps are down to the oestrogen/ crinone combination that I am taking as she doesn't like it.

Crinone has less progesterone than utrogestan, which she is not happy about, despite there being more than a mirena coil which she would like!

However, I did have polyps removed before HRT so I know it is not necessarily cause/effect.

[QueenofReds3]

Keep us posted AKatieD.
They wanted me to have the mirena fitted but I declined they seem to be in favour of it over other progs. X

[applejack]

Virtually every doctor said "mirena" to me. It seems to be the go to advice. And after all that it still didn't work!