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[Lesley2222]

During my 40's I was diagnosed with fibroids and initially offered high dose progesterone treatment which stopped the heavy bleeding.  I was then offered a hysterectomy but I asked if I could try a low dose progesterone to see if it controlled the symptoms.  I stayed on a progesterone only mini pill and felt great until I reached 53 when my GP insisted I came off them.  I had a pretty mild menopause not having a period from age 45 (probably because of the mini-pill) and used the Ladycare magnet).
 
In Jan 2016 at age 59 I began to experience post menopausal bleeding and was fast track referred to Derriford Hospital gyn.  In Feb 2016 I had transvaginal ultrasound followed by hysteroscopy which diagnosed a half inch polyp. At this time my womb lining was measured as 4.7 and ovaries looked normal. Polyp removed under general anaesthetic in March 2016 and given all clear.  In August 2016 (now aged 60) I experienced more post menopausal bleeding and was again fast tracked – I saw a different consultant yesterday who performed a transvaginal ultrasound and took endometrial samples for biopsy.

In the post examination talk the consultation said that I may have endometrial hyperplasia and said that after results came back she would suggest a Mirena Coil be fitted.

I have read the approved Nice guideline for the Management of Endometrial Hyperplasia published by the Royal College of Obstetricians and Gynaecologists;
http://bsge.org.uk/wp-content/uploads/2016/03/gtg_67_endometrial_hyperplasia.pdf

I've looked up the Mirena Coil and it's a slow release progesterone IUS.  I would happily go back onto a progesterone only mini pill in preference, having experienced unsuccessful attempts at having a coil fitted when I was in my 30's.  Has anybody else had this treatment at this stage of life and are there alternatives? 

[CLKD]

   I'm really surprised that no-one has answered your query.

Many ladies find that the Mirena is useful but undoubtedly, if you have problems with internals in the past, it won't be something to look forwards too  !  If you do a 'search' for "Mirena Coil" you'll see threads already discussing this type of treatment.

Browse round.  Join in! 

[Hurdity]

Hi Lesley2222

  from me too.

Have any of your investigations ascertained what has happened to the fibroids? They usually shrink in post-menopause in the absence of oestrogen although since you developed a polyp in post-menopause maybe the fibroids are also still there.

I read in the link you gave that sometimes endometrial hyperplasia is present in the polyp? Was this the case for yours - but I presume as you say the results were all clear then everything  was OK then?

I would ask what thickness your womb lining is now - from your recent scan - in fact the consultant should have been able to give you this information from the TVS. Did the consultant also perform a hysteroscopy? If not I would ask if s/he noticed any irregularities.

I see from the advice that the Mirena is recommended if you have endomatrial hyperplasia (without atypia - ie the cells haven't undergone possibly pre-cancerous changes) - but I would wait for the consultant to confirm this. If you are opposed to a Mirena then progestogens can be given orally -  such as norethisterone or medroxyprogesterone. I see that the treatment is given for 6-12 months (only had a quick look at the info) to see if the hyperplasia has regressed and if not a hysterectomy is performed.

I presume the bleeding is either from a thickened lining and leading to hyperplasia, or from fibroids or polyps but at your age you should have very little oestrogen, unless you are very overweight (hope you don't mind my asking)?

Normally with progestogens given continuously in the absence of oestrogen, the endometrium can atrophy and this can cause ulceration and then more light bleeding or spotting. If there is an oestrogen source in your body and your endometrium is thickening anyway then it may be OK to have a Mirena - but this could be in for 5 years. I think in your position I would go for the oral progestogens, the only disadvantage being if you are intolerant of them - there may be more side effects than the Mirena which delivers most of the progestogen locally. I presume as per the guidelines you will have regular checks anyway.

A bit of a ramble again - just giving my thoughts out loud - sorry i don't really know enough about it but the link was very helpful

Hurdity x

PS CLKD - you answered Lesley's post after a very short time - only 2 hours so not sure why you would be surprised. if it was a day - then I would be - but even then some posts get missed!! We all have busy lives and don't all have the time and inclination to spend half our day on the forum reading and answering almost every post! I only answer a few as - if I am on here for an hour - I might only answer 4 posts - some of them take 20-30 minutes to read, look up stuff and then reply!!!! It's also the summer and gardens beckon....

[walking the dog]

Hi Lesley 2222  I have endometrial hyperplasia and erratic bleeding my linings 8mm I'm now on (6 weeks in) 200 mg continuously of utrogestran and 50mcg estradoit patch its early days to see if it will help I'm back at specialist Oct, but I assume if I'm on it its an option for others ? Good luck xx

[linz57]

Sorry, don't want to hijack this thread but could I just ask  you wtd, were you prescribed your current regime by your doctor or the specialist ? I ask because I need to thin my lining but my own doctor won't prescribe the Utrogestan and estrogen patch, neither will she prescribe the coil. I have been referred to a gynae. Thanks.

[Lesley2222]

Thanks Hurdity and everyone else for their very quick replies.  No mention was made of the fibroids so I assume they disappeared post menopause.  Nothing was said post surgery about endometrial hyperplasia being present in the polyp.  The new consultant didn't tell me the current thickness of the womb lining and I didn't really think to ask.  She performed a hysteroscopy at the same time as taking the biopsy. I am overweight and have a current bmi of 35 - I've lost 5 kilo in the last 6 months and am taking the weight loss slow and steady in the hope that it doesn't come piling back on!  I'm feeling a bit less confused about it all today and feel more informed with my options - I'll know what to ask when the results come through.

[walking the dog]

Hi linz57 I was prescribed this by a gynaecologist specialising in the menopause however my gp writes the prescription for the hrt I am on my  second month of it hope you get sorted

[linz57]