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[Tulip123]

I've been referred due to irregular bleeding and I can't stop worrying about it.
I'm on perimenopause and I have been on HRT for 9 months. Prior to that, I was on the combined pill which regulated my periods.

Since I stopped the combined pill, my natural periods came back and they are painful and irregular as they were when I was very young and that's why I went on the pill in the first place. I'm also getting a withdrawal bleed from the Utrogestran, so with that and the irregular periods, I had three bleeds last month and two bleeds this month. I can't predict when my natural period will come.

My GP has now referred me to gynaecology for more investigations. I really don't know what to expect and I've made the mistake of trying to inform myself online and reading horror stories about a hysterectomy and complications afterwards. I'm very active and enjoy outdoor activities every week , so I am hoping they can offer something that is not as severe as a hysterectomy.

I know there are options like the mini pill but my GP wants to check if there is anything else wrong which is causing the irregular bleeding so I am not taking the mini pill yet.

I'm currently on Evorel 50 patches and utrogestran for half the month.

If they don't find the cause of the irregular bleeding, would they still want to avoid doing a hysterectomy? I am just hoping there is something else they can offer me.

[CLKD]

Remember that you don't have to agree to anything.  This is your body.  There should be a reason why HRT is causing this irregular bleeding, for some it's 'within normal limits' and a total nuisance.

Make a list of your worries to take to the appt..  Once you've seen the Gynae, depending on whether you feel supported in that he/she knows enough about peri and HRT, you may want to be referred to a dedicated menopause clinic.  Gynaes often don't know enough about 'womens' problems'! 

Hopefully someone will be along to suggest what else you might try so that you are armed with info to take to the appt..  Let us know how you get on.  I had painful periods for many years, until I went on The Pill.  You have my sympathy.  Have U tried 'feminax'?  Hysterectomy would solve the pain but that is major surgery. HRT must be discussed B4 opting for that though many Surgeons don't even consider the necessity to inform ladies what they may require.

[Tulip123]

Thanks for your reply. I think my body was always like this. My periods were terrible when I was younger and then the pill resolved it. Now I'm off the pill and my periods are back to when I was 16 again . I've never had regular "natural" periods in my life but the answer back then was just to put me on the contraceptive pill which was Mercilon, a combined pill.

The GP mentioned that I'd probably be seen by the menopause clinic which I presume comes under gynaecology.

I've had a blood test at my GP surgery and everything was ok on that.

Today she wrote me a prescription for mefenamic acid for the pain. I haven't tried this before but I'll pick it up tomorrow.

[CLKD]

A menopause clinic is usually separate to an Obs and Gynae appt., I would ring to find out.  The GP should have explained! 

Do try the mefenamic acid - I used 'feminax' the idea being to begin it 2 days B4 a period is due.  Let us know how you get on. 

[Tulip123]

Thanks, she didn't tell me I had to take it before my period was due.

[mandss]

Awe hun I could have written your post myself. Since starting HRT about 5 years ago I just bled randomly. The only time I did not bleed was for 5 months when I came off it. I tried patches, tablets and the coil. Had scans, biopsies the lot, nothing showed up. Eventually last year I went private and the consultant was brilliant. He said he could not see any other way forward with the hrt so recommended a hysterectomy. It turned out I had severe adenomyosis, a bulky wonky womb, an inflammed cervix, cell changes, cysts and cervicistus. So far it has been the best thing I ever did. No more pain,no more bleeding and more estrogen. Let me know what happens....

[Tulip123]

Awe hun I could have written your post myself. Since starting HRT about 5 years ago I just bled randomly. The only time I did not bleed was for 5 months when I came off it. I tried patches, tablets and the coil. Had scans, biopsies the lot, nothing showed up. Eventually last year I went private and the consultant was brilliant. He said he could not see any other way forward with the hrt so recommended a hysterectomy. It turned out I had severe adenomyosis, a bulky wonky womb, an inflammed cervix, cell changes, cysts and cervicistus. So far it has been the best thing I ever did. No more pain,no more bleeding and more estrogen. Let me know what happens....

Thanks, I think I might have a long road ahead with this.
I know a hysterectomy would solve it but I'm just scared about what happens to my body afterwards. I keep reading about things like prolapses, bladder problems, not being able to return to the activity I do now (I walk for several hours per week).

[Taz2]

I think hysterectomy is the last resort particularly due to the high cost so other treatments would be offered first. It could be that you have fibroids especially as your periods are painful. Have you considered the mirena coil? This is often the recommended treatment once scans have been done to rule out any other problem.

Taz x

[Tulip123]

I think hysterectomy is the last resort particularly due to the high cost so other treatments would be offered first. It could be that you have fibroids especially as your periods are painful. Have you considered the mirena coil? This is often the recommended treatment once scans have been done to rule out any other problem.

Taz x

Yes I have been told there is an option of a coil or mini pill but I think the GP wants me to get checked out first before I start one of those.
If they don't find anything serious, then I'd like to try the mini pill first. My cousin takes that and has no bleeds at all. However, my sister tried it and had bad side effects so it's just a case of trial and error.

 I was a bit nervous of a coil because I find smear tests very traumatic and I've not had children. For smear tests, I now do the private home test which is a much smaller instrument and the you send the sample straight to the lab.

[Clovie]

Tulip

I have been in almost the identical situation to you recently.
Please see my thread called 'Still Regular Bleeds age 58' https://www.menopausematters.co.uk/forum/index.php/topic,64739.0.html

I too was having regular predicable bleeds of my own plus the utrogestan withdrawal bleeding - which caused me severe anaemia!


I was sent for a scan because I could NOT be POSSIBLY having my own periods at my age, - yet at the scan I was told my womb was indeed that of a still menstruating woman, that there were no abnormalities and my lining was thin, everything perfect.

Please try not to worry too much about your investigations, they will prob start with abdominal scan anyway, and it may show no further investigations needed.

I was put onto continuous 100mg Utrogestan 5 months ago and I'm STILL having my own regular bleeds with all the PMT beforehand. HRT apparently does not stop your own cycle.
I was offered Mirena but declined for 2 reasons - one was I have heard horrible stories about insertion and two - I am  progesterone intolerant. Utrogestan is the only prog I can tolerate.

I've started a few threads lately about this, such as 'Is There An Age where the NHS Will Take you off HRT?' because the doctors scared me so much, and when all looked well, still spoke of taking me off HRT due to my age. Ridiculous as I need the HRT now given I haven't gone through menopause yet and my symptoms if not on HRT make me and my entire life unbearable. (And my husband's!  )

Feel free to PM me if you think it might help.
Good luck x

[Tulip123]

Tulip

I have been in almost the identical situation to you recently.
Please see my thread called 'Still Regular Bleeds age 58' https://www.menopausematters.co.uk/forum/index.php/topic,64739.0.html

I too was having regular predicable bleeds of my own plus the utrogestan withdrawal bleeding - which caused me severe anaemia!


I was sent for a scan because I could NOT be POSSIBLY having my own periods at my age, - yet at the scan I was told my womb was indeed that of a still menstruating woman, that there were no abnormalities and my lining was thin, everything perfect.

Please try not to worry too much about your investigations, they will prob start with abdominal scan anyway, and it may show no further investigations needed.

I was put onto continuous 100mg Utrogestan 5 months ago and I'm STILL having my own regular bleeds with all the PMT beforehand. HRT apparently does not stop your own cycle.
I was offered Mirena but declined for 2 reasons - one was I have heard horrible stories about insertion and two - I am  progesterone intolerant. Utrogestan is the only prog I can tolerate.

I've started a few threads lately about this, such as 'Is There An Age where the NHS Will Take you off HRT?' because the doctors scared me so much, and when all looked well, still spoke of taking me off HRT due to my age. Ridiculous as I need the HRT now given I haven't gone through menopause yet and my symptoms if not on HRT make me and my entire life unbearable. (And my husband's!  )

Feel free to PM me if you think it might help.
Good luck x

Thank you Clovie, I will read your thread.

When I started HRT, I presumed it worked like my contraceptive pill and I'd have the withdrawal bleed but that was all, no natural period. Sadly nobody explained this to me. It was important as I'm only 47 so have not reached the average age of menopause.

I'm hoping as you say that a scan will show everything is ok and I don't need surgery. My natural pèriods were never regular before the contraceptive pill and were always painful. The answer at age 16 to stop all that was just to start the contraceptive pill and I was fine for 30 years until now.

I have the same concerns as you about getting a coil but I'm willing to try the mini pill if it will solve all this. I can't do that until I've had some tests though to make sure it's not serious.