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[Annemaria]

Hello,
I'm a 58 year old 7 yrs. post menopausal. I've been taking .6 premarin and 2.5 Medroxyprogesterone daily for 5 yrs. I decided to wean myself off slowly and starting taking the above every other day with no problems for a year and then went down to 1/2 dosage every other day for the past 7 months.  Things were going fine until two weeks ago I had very sore breasts and nipples.  It felt like I was going to have my period. Well, sure enough I started spotting 4 days later.  Dr. sent me for an internal ultrasound and it showed my uterine lining at 8mm. I'm now waiting for an appointment for a biopsy. Needless to say I'm quite worried about this. Anyone here have had a similar situation?

[Hurdity]

Sometimes the lining can build up on combi HRT because it is prepared at one dose but some women absorb it better than others so need a higher progestogen dose to keep the lining thin. Also sometimes if you are taking oral HRT and something happens to alter your digestion then your levels could fluctuate and if progesterone levels fall as a result, and the lining has built up a little - then some of it may  be shed and you could get pre-menstrual symptoms as you experienced.

8 mm is not overly high although ideally it should be lower than this on continuous combined HRT. Mine was over 7 mm when it was last measured - although I am on cyclical HRT so this is expected as it builds and sheds.

The gynae is only doing his/her job by referring you and it's good to have this test hopefully to reassure you that all is OK. I had to have similar - hysteroscopy and biopsy (because of the thick lining and scan showed abnormality - which turned out to be small fibroid so OK).  I had mine done in a city hopsital with no anaesthetic - just painkillers beforehand - and the gynae was brilliant. I had no pain at all. Some opt to have it done under GA.

Try not to worry and hopefully the biopsy appointment will come soon and will show that all is well.

Hurdity x

[Annemaria]

Hi Hurdity,
Thank you for your reply. I appreciate it very much. My appointment is on Tuesday. I wish I could ease my mind, but the more I read on the internet, the more terrified I get.

[flutterby]

Hi Annemaria
Last October after being on Evorel Sequi for several years (HRT for 15 years, I am 63) and having a monthly bleed, with no complications I suddenly started spotting and also noticed an increase in vaginal discharge. I was straight on the Internet and liked you scared myself witless. I went to my GP who said the symptoms that were causing me to the think the worst were common with women on HRT.
My endometrial lining was 6.5mm I had a biopsy taken with a local cervical anaesthetic so not painful. Nothing was found.
I put myself through hell for nearly six weeks mainly because of what I read on the internet.
My next ultrasound the lining was down to about 2.5 and 4 months later it is back up to 6 even though the last 5 months I've been on continuous HRT. They have called me in again to discuss it and possibly offer another biopsy. This time I have the mind set as Hurdity says they are only doing their job and it is highly likely to be the HRT and I am determined not to worry ( although I am a very anxious person anyway). So Annemaria, please do not check the internet any more, in my experience it seems to gives the worst case scenario. Flutterby xx

[Annemaria]

Hi Flutterby,
Yes, I have read more than I should have been. I have stopped and along with your words above, I'm feeling more calm now. Thank you for your reply Flutterby, it really did make a difference.
Annemaria

[flutterby]

Hi Annemaria
Hope everything went well today
Flutterby x

[Annemaria]

Hi Flutterby,
Well my gyn is sending me in for a D&C with Hysteroscopy next Thursday. She said she didn't want to torture me any further as she couldn't get a sample. She did put everything in perspective about how this most likely came about with my dramatically cutting down on HRT which according to her caused an estrogen build/hormone surge hence the bleeding.
She was very comforting and assured me I'll be fine. I am feeling a bit lighter now. 
Thank you for caring and your calming words.
Annemaria

[flutterby]

Hi Annemaria
Glad to hear you are feeling less worried.
When I had my biopsy done, although the gynaecologist was very good and gentle he also struggled to get samples and actually told me that I might have to go for a further procedure ( presumably D&C) if the histologist said there wasn't a sufficient sample as it was in the end there were enough cells.
Flutterby x

[linz57]

Hi Annemaria, I recently had a D&C along with hysteroscopy and biopsies due to bleeding after being on conti hrt for some time. All my results came back clear ( my endometrial lining was 6.5mm) and the gynae said the same as Hurdity so I hope this reassures you further. 

[Annemaria]

Thank you Linz57 for your reply. It is comforting to hear others' experiences.

[Annemaria]

Flutterby,  wondering how your latest issues have been resolved. Yours are so very similar to mine.
Take care,
Annemaria

[flutterby]

Hi Annemaria
After almost a full week of no spotting I had 2 consecutive days of small bleeds. I don't feel very confident that the bleeding will stop with this HRT regime. I did plan to come of HRT in September but as it approaches I am having second thoughts.
I go to see the gynaecologist a week on Thursday.
Flutterby x

[Annemaria]

Back from my d&c and hysteroscopy. Lining of my uterus was actually thin! She said not suspicious at all.
Procedure was a breeze mainly because I was in neverland. 
Thank you all above for helping me through my anxiety.
Annemaria

[flutterby]

Pleased to hear everything ok. Flutterby x

[Annemaria]

Wish you well also Flutterby.