Post-menopausal bleeding - consultant appointment and worried

[ChristmasFairyLiquid]

Hoping someone can give me some words of reassurance or at least an idea of what to expect.

I had a post-menopausal bleed (felt exactly like a period - 5 days long with sore boobs in the run up) last month.

Contacted the doctor as you’re meant to and had an ultrasound and internal scan last week.

Have just been called for an appointment with a consultant at the hospital on Saturday which has terrified me. Does anyone know if this is standard, or what it might mean, or what I can expect? Thank you for any info.

I had post menopausal bleeding 3 yrs ago, scan, tests camera up there, biopsies etc. eventually got told that I had abnormal cells but not yet cancer. Had a biopsy every three months to keep an eye on my situation, not very pleasant - no option for general anaesthetic where I live ( even for my 80 yr old mum who went through the same thing) painful but not agonising. I was told by my consultant ( fabulous female consultant) that having abnormal cells increased your chances of developing cancer. I was given the choice either keep getting the biopsies every 3 months or opt for a hysterectomy I ended up having 4 biopsies and that was plenty for me. given my age ( late 50’s) it was a no brainer for me and I opted for the hysterectomy. Which was performed by my consultant and I don’t regret my choice for a minute even though complications from a previous unrelated surgery meant I had to have a full surgical scar rather than laparoscopic surgery.

Hi all, had the WID easy test today. Just like having a smear so no big deal. That's been sent away. It can recognise uterine cancer cells. Had another scan...the consultant showed me what she thinks is a polyp but can't be sure. Lining 6.7mm. So got to have the hystroacopy to remove the polyp. But she was really helpful, I have loads of info on it now so that I can make an informed choice. She even gave me the numbing syringe with numbing liquid in it to use 20 minutes before the procedure. Interestingly I adjed if she had to have the hystroscopy would she have it under GA or local...she said local first option but with numbing and probably local anaesthetic. Not with no pain relief.

@Ann1968 I read about that new test I hope it gets rolled out across the UK soon

I had post-meno bleeding that was exactly like a period.
Turns out it was exactly like @Oopsps .

At our trust the GA is policy for hysteroscopy now. Scan and hysteroscopy is the gold standard investigation for post-menopausal bleeding, which is reassuring (even though for those of us inclined to bleed at the drop of a hat it can be a tad tedious).

Regarding pain relief for the hysteroscopy, mine hurt and honestly was a bit degrading in the way it was done. But I would probably opt to do without sedation etc again.

However, what I wasn't prepared for was the pain afterwards. I had a few days of horrendous cramping pain, to the point I felt sick and faint. Lovely (female) GP prescribed proper pain relief which helped a lot, and I took a few days off work to curl up with hot water bottles.

Wishing you all the best OP.

@Ann1968 really pleased you got your test and it was straightforward, and found a sympathetic consultant. Fingers crossed for the next stage, hope that all goes smoothly.

@Saz12 sounds like that is more common than I’d thought, pleased it turned out the same for you as for @Oopsps.

@Kissedbyfire1 that’s good to hear and @FedUpandEatingChocolate so sorry you had such an awful time afterwards - thank you for the well wishes.

Interestingly I spoke to the doctor today when they rang about something else (for DD, it never rains but it pours 😫) - anyway, I asked if I should read anything into the consultant appointment, does it always suggest they’ve found something.

She said the initial referral automatically leads to a consultant appointment - and the ultrasound/transvaginal scan is a precursor to that - so you can’t read anything into the fact that the consultant wants to see you. Which was reassuring - obviously doesn’t mean there isn't anything of concern, but also doesn’t mean there is.

(And is at odds with what the sonographer said, that I should expect a follow up appointment if the doctor was ‘very concerned’, so I think they need to do some training there. He was a lovely man but more thoughtful speaking could save a lot of worry!)

I had a similar bleed, referred for a scan they found a cyst on my ovary. Day surgery to remove the ovary, which was then found to be cancer free. No further problems. Hope all goes well for you.

Thank you @Autumnnow - pleased yours all turned out ok.

They have been using the test in Austria and Switzerland for years. NHS gave approved it but it's just not available yet. Most private hospitals don't offer yet but some smaller groups do. There is a London clinic, a Manchester clinic and a Glasgow clinic that I know offer it. It's not cheap at £ 300 currently.

Thanks. I do have a polyp and they don't know if it's cancerous so hopefully the WID test will tell me. Ultimately it still needs removing though as they can become cancerous, but it gives me more time yo make decisions if it's not cancerous currently.

That's bad. Nothing should be degrading. As for pain relief, I discussed it yesterday with the lovely doctor. You can be given numbing gel that you apply before, take pain killers and also have a local anaesthetic. Then it should be just pressure that is felt rather than pain. Sorry that it was degrading ....that's disgusting. Please complain formally.

I have just experienced exactly the same.
Postmenopausal bleed after 12 months of no bleeding.
was in and off for 3 months.
2 week fast track the same as you. Suspected Gynaecological cancer it said on referral.
i have had the same after scan called me in for a Hysteriscopy and biopsy.
I was called back due to thickened uterus lining.
Diagnosed with 4 Fibroids, 5 cysts. 1 Fibroids large, Cysts large.
Biopsies clear no cancer cells. Blood tests for cancer markers (CA125) clear.
I need to go back after 3 and 6 months for scans to check growth of Fibroids and cyst.
I am still bleeding in and off and this is hormonal.
I have to say it is a worrying time but majority of cases are non cancerous.
I think the 2 week fast track is a precaution.
Hope all goes well.

I’m going through the same process and my ultrasound and consult apt were scheduled for the same day. It’s normal procedure, the consultant needs to review the ultrasound and assess you.
When I initially spoke to my GP he said that he had to do a 2 week wait referral as it’s a red flag but it’s very highly likely to be something benign.
if I read it right that it’s only 12 months since your period stopped, then my understanding is that it’s not uncommon for periods to return in that timeframe.
I know it’s hard, but try not to worry!

@Ann1968 I hope your results come back ok - please keep us posted.

@boombasticfantastic and @Newyorklady thenk you for your posts, it’s really good to know you had similar. It is horrible to go through but comforting that there are so many of us experiencing it.

@boombasticfantastic your doctor sounds more empathetic or just a better communicator than mine, what a difference it would make if they all pointed out that it’s a necessary process but one where most people don’t get terrible news.

Yes you did read it right, 12 months almost to the day, and I’ve read quite a few cases like this in the last week. So fingers crossed….

Just coming back to say that the way mine worked out was that the consultant attempted the ultrasound and couldn't get a clear view because I have a tilted uterus so she took the biopsy and booked me in at my local ultrasound clinic two days later (5 mins walk from home vs another 20 mile round trip to main hospital). Then I had a letter from her a few days layer saying the biopsy was clear but she would see me for a hysteroscopy under GA if I have any more bleeding. My situation is that I am late 50s but have had no periods for about 15 years because of having mirena coils. No other real meno symptoms. So no idea where I was in the process but I have a family history of late menopause. My GP thought my bleeding, which was only spotting, was a last hoorah combined with my 10 year old mirena finally running out of progesterone so she removed that and I had a full 5 day bleed which was weird after so long, I had to steal pads off my DD.

This happened to me with post menopausal bleeding. They just found fibroids which are so common most people have them without knowing.

Thank you @ExtraDecluttering and @runningrunningrun - helpful to hear your experiences too.

My appointment is this afternoon so I’ll report back later.

I’m due a hysteroscopy under 2ww on Wednesday where I think they plan to do a hysteroscopy - if I wanted a general anaesthetic instead should I phone ahead or wait and say on the day?

Have you had your ultrasound and consultant apt yet? The procedure would be fine after this. My initial letter said they may want to do a hysteroscopy on the day but in practice I don’t think it’s how it normally happens.
if you want it done under GA then you’ll need to go through the usual pre-op assessment process. It won’t get done on the day.
my experience was a positive one. The consultant explained the procedure and my options and made it clear that GA / not GA was my decision. I said GA please and was completely supported in this choice.

@boombasticfantastic thanks - I’ve already had ultrasound in which she mentioned thickened lining - I also have stage 4 endo (diagnosed previously) and letter for next appt includes a hysteroscopy leaflet so now thinking it’s not a chat with gynae but straight into hysteroscopy …

Good luck

Ok so reporting back as promised - I had my consultant appointment this afternoon.

i have a slightly thickened uterine lining (5.5mm as opposed to about 4 inches that he would expect in menopause, I think was what he said). And a 2cm ovarian cyst.

He said a cyst of that size is v common and can resolve itself.

He also said the bleeding was almost certain to be a ‘last hurrah’ period as PP have had, he said he sees that a lot. And it’s unrelated to the cyst or the thickened lining.

He offered me a Hysteroscopy there and then which I declined based on the advice from you lovely lot, so will get an appointment sent through for that and he’s noted I want pain relief,

I also need to book a blood test and I will be scanned in another 4 months to keep an eye on the cyst. He also did an internal exam and felt my tummy which he seemed happy with.

He seemed pretty relaxed about it all which I took as a good sign. Thank you for all the support which has made this week easier to
get through - and I will update on the ongoing investigations as I have them.

Well wishes to all of you who are going through similar 💐

Well I'm so glad that it went smoothly today.

That all sounds positive though and glad it's behind you !

My hysteroscopy is 14th April. Wish me luck !