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post meno bleeding(18 Posts)
This happened to me, really heavy and completely out of the blue. Have seen a gynae who examined me and took a biopsy, results will not be back for two weeks. I also had a transvaginal scan. The gynae was in the room when the radiologists took the scan. Went back to the consulting room afterwards and when I asked the results of the scan he told me there was nothing overt he could see.
He then told me if it proved to be a polyp it would be removed by hysteroscopy but if the biopsy showed pre cancer hyperplasia then that would be hysteroscopy plus Mirena coil with review in three months. Also why a Mirena coil when I'm years and years post meno? I forgot to ask.
Final diagnosis could be cancer which would mean hysterectomy. He was reassuring about this and said it was one of the "better" cancers as its usually contained. So ...... its a waiting game. Also I forgot to ask him if being on Ovestin for a number of years could be responsible.
Sorry to ramble, Hoping for the first diagnosis but just wondered if anyone else is/has been in the same boat and how things worked out.
I would pop this on the meno threads.
Sorry you are having this worry.
Ovestin is completely safe to use long term and wouldn't have caused your womb thickening.
The Mirena coil is used to prevent the womb lining getting thick again, common to be prescribed it for that reason in peri/post menopausal women.
Thanks for your reply. Very reassuring. Will post this in meno.
I meant to mention this site earlier
Be reassured, they can see a lot on scans and if there was anything it would most likely have shown up.They could have told you what the thickness of the lining was. Hyperplasia is a thicker lining. They measure it in mms. They would be able to tell from the scan if you had hyperplasia. Might be worth asking when you see him or talk again?
Most likely to be a late period- how long since you had one?
Thanks as always Polly. The gynaes words after the scan was that there was "nothing overt". I now have a copy of the clinic letter which says: "endometrium approx 12 mm including fluid (soon after pipelle)" so maybe that was excess fluid because of the biopsy 20 mins before scan.
Don't think it could have been a period as the last one must have been nearly 20 years ago!!
Ah- so you must be in your mid 60s or older unless you had POF?
It does sound as if there could be hyperplasia but the treatment should be straightforward and the good news is they didn't appear to find a tumour of any kind.
I don't understand the biopsy / fluid- did they not just insert the pipelle? They don't use fluid for that. (Had it done!)
Try not to worry- will all be okay!
What's POF Polly? Hyperplasia is one of his suggestions. Hope its the simple sort if its not a polyp. Would the scan have been affected by having a very full bladder. Would that explain the fluid?
POF- premature ovarian failure- menopause before age 40 ( or 45).
If you have not had periods for 20 years are you 70s - based on average age of meno being 51?
If you had a transvaginal scan there was no need to have a full bladder. They don't need a full bladder to scan you that way- one of the perks of it!
No, I'm not a dr, but have had many scans. My understanding is that fluid is fluid within the tissues of the lining.
It's a shame you have to wait 2 weeks for the result- see if you can hurry it along and get some answers.
Just an update. Saw my GP today and we discussed the tranvaginal scan results. She said they were a bit high but she would have been more worried if some parts of the endometrium had been reported as thin and then there had been a thick part as that could have been suspicious. She said the fluid mentioned in the report was probably the results of the bleed I had had a few hours earlier. Also she mentioned Ovestin could cause endometrium thickening and looking through he literature I read that its one of the contra indications for taking it. I've been on it on and off for about fifteen years and never realised this.
Ovestin does not cause thickening. It can be used for decades- I know of women in their 80s using it.
This is what NICE says:
1.4.9 Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
1.4.10 Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
1.4.11 If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
1.4.12 Explain to women with urogenital atrophy that:
symptoms often come back when treatment is stopped
adverse effects from vaginal oestrogen are very rare
they should report unscheduled vaginal bleeding to their GP.
1.4.13 Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
1.4.14 Do not offer routine monitoring of endometrial thickness during treatment for urogenital atrophy [In other words, it is not a risk] .
This may or may not apply. Post meno our estrogen levels are very low without HRT. But women's fat cells continue to produce estrogen in small amounts. Being overweight post meno is one risk factor for hyperplasia because it means there is more estrogen circulating which is not being 'mopped up' by cyclic progesterone as it would be in our fertile lives.
Whatever the outcome of your biopsy, and let's keep everything crossed, it may help to be aware of what can increase risk.
Re the Ovestin I think the GP was considering this:" if you have excessive thickening of the womb lining" which I apparently have but obviously I had no idea until I had the bleeding. I read the package leaflet yesterday and it does say the endometrium can become thicker. I spoke to my gynae yesterday and reassured me re the scan but was surprised when I told him how long I had been using Ovestin (originally prescribed about 15 years ago, called something else then). At that stage and for a few years I only took it as recommended.
GPs are not experts. I have lost track of the misinformation reported here by posters compared to consultants who are menopause specialists.
The leaflets are a 'cover all' to cover the manufacturers. The information is not always up to date.
If you have not had a period for 20 years then the amount of Ovestin should not - in my opinion- have caused a massive heavy bleed. This is why NICE says it can be used forever and no routine monitoring of the endometrium is needed.
The dose of Ovestin is 0.5mgs. You need to use it thousands of times to even get to 1gm (the lowest dose of oral HRT taken daily.)
The absorption rate into the system is LESS the more it's used because the vaginal mucosa (walls) absorb LESS when they are healthy (and not atrophied.) The cells are strengthened so the estrogen does not get into the blood stream. There are women who have had B Cancer who can use it.
I didn't mean the above post to sound aggressive in any way.
Did you not have any bleeding at all in the 20 years since your last period? often when the lining is getting thick some women get really slight spotting- even just one tiny smear of blood now and then, which should be reported. It's sometimes a way of knowing the lining is building up.
Have you ever used systemic HRT as well as Ovestin?
Just an update. The biospy results took forever and it appears the nurse put the wrong label on the specimen. Had this done privately and there is an investigation going on now. However the gynae repeated the biopsy on Tuesday night and in his words "felt positive it would be OK". He gets the results by Monday and has booked me in for a hysteroscopy. If he doesn't find polyps but the endometrium is thickened does that mean a Mirena coil? As far as I know its being done under local. Any reassurances would be great.
I had thickening of the lining of the womb twice while on HRT and had a Myrena coil. Two D & Cs later was advised to stop HRT because the same thing would happen again This was in 2015 and since then have had to suffer from hot flushes, mood swings etc.
If you want to remain on HRT after the hysteroscopy (think that's what is now called what we used to know as a D &C !) then yes you will need a Myrena fitted to protect the womb. Best of luck with your biopsy results.
What a shambles to lose your biopsy sample.
I think you just have to wait till Monday. There are various treatments if it's hyperplasia- usually the Mirena or oral Norethisterone.
Let us know what the results are.
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