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[Kaily]

I have been on Evorel Sequi for over 2 years. Sometimes I get the monthly bleed, sometimes not. This last month I started spotting which then turned into period like bleeding for a month. I am 57 and suffered badly with endometriosis before my periods became infrequent with the
beginning of the menopause.

I have pain and bloating along with the bleeding. Should I be worried?

I have an appointment with my GP on the 24th.

 

[Hurdity]

Hi Kaily

 

Sorry to hear about your bleeding. You've done the right thing in getting doctor's appointment so that you can get checked out. Do you know where your endometriosis was ie was it confined mainly to the womb?

There is some information on this website about it:

Endometriosis   
    There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis.
    See the Induced menopause in women with endometriosis factsheet

https://www.menopausematters.co.uk/atoz.php#GlossE

If you go to that link above it will take you to the other link and factsheet.

I wonder if you are able to ask for an earlier appoinment ie this week? Can you explain that you are worried about the abnormal bleeding which it is as you were bleeding for a month on cyclical HRT when sometimes you get no bleeds. Personally this is a good reason to go sooner - say to the receptionists you would like to be seen this week. If you were younger then it could easily be due to the vagaries of peri-menopause but as you are 57 - this should not really happen - so the endometriosis might have flared up. In addition if it is causing you pain as well I would defo mention it.

In the meantime, try not to worry, and do all your Christmas preparaton to take your mind off it. I hope you manage to get an earlier appointment, and are able to get the next step sorted soon eg a scan or referral if that's what the doc suggests.

Do let us know and all the best

Hurdity x

[Kaily]

Thanks so much for taking the time to reply Hurdity and the for link.

I don't know where my endo is/was but I do know I also had Adenomyosis. I did actually try and get an appointment today but they had all gone. The Doctor I see only works 2 days a week so I will try again next week.

Yes I will definitely update this when I know more and thanks again.

[Kaily]

I saw the GP on Tuesday and she has referred me for a scan urgently although she did say she wasn't too concerned. It should be within the next 2 weeks but what with Christmas might be a bit longer. At my request she didn't examine me internally, seemed little point as it wasn't going to establish what was wrong.

Bleeding still hasn't stopped, if anything it is getting worse.

Feeling blah.

[Hurdity]

Thanks for the update Kaily - but sorry to hear about the ongoing bleeding . Hopefully you will have the scan soon and then the docs can decide how best to proceed re HRT. In the meantime have they given you anything to stem the flow - there are treatments such as Tranexamic Acid or a strong progestgoen like Provera or norethisterone? There is info on this site: https://www.menopausematters.co.uk/periodtreatments.php.

All the best

Hurdity x

[Kaily]

Thanks again Hurdity.

No I wasn't given any medication or taken off the HRT. Just have to wait for the scan.

[Kaily]

UPDATE

I had the scan a month or so ago. It showed a slightly thickened lining 6mm and a fibroid of about 6 cm. This was followed up with a one off appointment with a gynaecologist who really just suggested changing from sequi to conti.

Thing is I am getting a lot of pain around where the fibroid is which is worrying me. When I had my scan they couldn't see my right ovary and that is the same side as the pain. I don't really know what my next step should be?

[Hurdity]

Hi kaily - thanks for the update

Did you mention the pain to the gynae? You said you had endometriosis and that is quite a big fibroid? Surely gynae suggested what treatment for this in addition to changing from sequi to conti? I would seek further advice if you can at this difficult time, and press them to discuss options for treatment. Have you checked out the NHS info re fibroid treatements here: https://www.nhs.uk/conditions/fibroids/treatment/ ?

Hurdity x

[Kaily]

Thanks.

My GP is sending me for a ca 125 blood test. See what happens from there.

The gynae was a man and just said stop the HRT if the fibroid is an issue.