Potential Uterine Cancer

[EgonSpengler]

Hi there,

Apologies for the random message as I'm slightly losing my mind here. I can't talk to anyone presently as my SEN DD13 is constantly with me (also has sonic hearing!) and my DH is out of the country until tomorrow (not point worrying him when there's nothing he can do).

I was bleeding for 4 weeks, progressively becoming heavier and flooding. Managed to get a Drs appt where they prescribed tranxemic acid to stop the bleeding (just spotting now) and referred me for a pelvic scan and bloods. Bloods all fine but scan has showed thickening of the womb lining which will need further investigation - I'm guessing this will be a biopsy?

I upped my oestrogel from 2 pumps to 3 then 4 (with my GP's knowledge) as my menopausal symptoms worsened. Could this be the cause? My mum is rather unhelpfully suggesting this is the case (therefore it's my fault obvs!).

Thanks for reading my ramble - I'm a bit scared! x

Please don't panic. From what I've read and heard from other women (I'm not a doctor), the thickening of the uterus is common and isn't usually cancer. I gather it is more common with HRT but can happen around menopause sometimes anyway. It does need investigating, which will hopefully just reassure you.

I've just been through other medical investigations, so I know it can be anxiety inducing, even when knowing it's probably fine. There's always that fear of the 'what if'. I hope you can get seen soon and be reassured.

Yes, please don't panic. I was referred for similar, and had thickened endometrium plus a fibroid. I had an operative hysteroscopy, biopsy and polyp removal. All tests came back clear. Some women have more reactive wombs. So please, please don't worry

Thank you both so much @BatshitCrazyWoman and @ForestBather xxx
I really appreciate your reassurance! With the test on Friday and then having to wait for Monday to get things going, my mind has gone into overdrive, especially with not being able to talk about it.

My mum had this in her early 50s and she was fine the fitted a coil and it stopped further bleeding. (This was 10 years ago now)

Did you increase your progesterone dosage alongside the Oestrogel? Not doing so can have that effect apparently.

I've had this twice now. Second scan apparently showed 'grossly thickened' endometrium, but because I was having the hysteroscopy/biopsy under general it wasn't done for another couple of weeks - by the time they did it lining was observed to be normal thickness. I opted to be fitted with a Mirena for the progesterone part of my HRT and bar a couple of months of incredibly light spotting as it settled I've had no more issues, even on 4 pumps a day.

Thank you @Mama9076 and @MassiveOvaryaction . That’s really reassuring. I’m on the 2ww pathway and hysteroscopy is booked for mid April, so it all seems to be moving as quickly as it can. I’ve stopped HRT for the time being (heaven help my family) under drs orders and maybe my womb lining will have decreased by then. I’ve gone back to flooding so think I’ll need some more tranxemic acid before the hysteroscopy as it’s like the Somme down there.

EgonSpengler if you are flooding now - please go and get the progesterone only mini pill - it will should stop that flooding. Also get onto iron tablets to make sure you are not anaemic. Don't do the combined . Hopefully you get your hysteroscopy done and it's all good.

I’m on one pump, and I was getting bleeding. I had a scan 6 months ago and womb lining was 4.5mm (which wasn’t good). Gynae upped my progesterone to 2 tablets daily and my lining is now the correct thickness. Did you up your progesterone when you increased your pumps? I hope it’s something as simple as this.

@gfedcba I am actually already on the mini pill! Flooding still happening unfortunately. Iron doesn’t seem to be too affected bizarrely. Blood tests came back as normal. Thank you! Fingers crossed.

@AgentProvocateur Glad it’s sorted now, must have been scary. My womb lining is 19mm which is very not good. I didn’t up my progesterone when I upped the oestrogen so really hoping it’s this. I did discuss upping the oestrogen with my gp and they never mentioned I needed to up the progesterone. Once this is all sorted (whichever way it goes) I think I’ll speak to a meno specialist.

Have a read of the previous threads about hysteroscopy. I went through something similar to you a few years ago. After the first painful experience of hysteroscopy, my gynaecologist told me not to put myself through that again and have it under general anaesthetic. Mine turned out to be okay in the end, and I hope it is the same for you.

Hello. I'm post menopausal on full hrt. I've had several episodes of bleeding and 2 separate 2 week urgent referrals to investigate.

1st was a scan that showed thickened womb lining. Increased progesterone and a few months later bending started again. Another 2 week referral, this time hysteroscopy with biopsies and had a coil put in.

In both cases biopsies were normal (phew).

The consultants who saw me could both tell a lot just by looking and were reassuring both times, with biopsy results confirming the same.

So get the scan/biopsies done asap and take it form there. Also get bloods done CA125 being the cervical cancer indicator.

I found it quite a scary thing to go through and was catastrophising quite a lot in the waiting times. I think that's normal though.

I hope that everything is ok for you. X

And @Asparename is right , opt for GA on the hysteroscopy if you can. I ended up having 2 and GA was definitely much better if a little disruptive.

Thanks so much @Asparename and @ooooohnoooooo. Really glad that both of your situations turned out okay.

I keep hilariously being told by male medics that a hysteroscopy is not painful and I should give it a go anyway and if it's bad maybe come back for a GA - why not just give a GA when I've clearly explained that because of a traumatic birth I really will need pain relief unless anyone wants to get punched in the throat.

They've said that a nurse will call me a few days before and will go through the procedure with me and that a local might be available.

I'm definitely catastrophising but trying to keep busy to block it out.

Yes you would normally double your progesterone when you doubled your oestrogen dose however I don’t know what the mini pill dose of progesterone is equivalent to, 4 pumps of oestrogel is normally balanced out by a Mirena or 200 mg of urtrogestan. Guidelines state there is generally not a need to stop hrt whilst awaiting a scan in these circumstances ,I wouldn’t worry at least you are going to be seen by the right people to exclude any other causes.

I wouldn't panic too much it just sounds like you're having a crappy menopause. Mine was similar, had to have a hysteroscopy, nothing bad going on, it was what it was and I'm so thankful to be out the other side!

@EgonSpengler re the pain. I birthed a 9 pounder at home so not a wimp. What follows is my experience and shared in a sisterly fashion so you have facts to make a decision, not to make you unnecessary scared. I was never one of 'those' women who share birth horror stories to 8 mth pregnant women. So read onwards with caution.

The 1st hysteroscopy was pretty uncomfortable and hurt. The getting past the cervix part for me was fine. When they fill the womb with saline the womb contracts (like early labour) to try and expel it. They offered me no pain relief at all but I had a (literal) hand to hold. It was not nice. I groaned quite a lot.

But when they wanted to cut out a polyp with no pain relief at all I just said no.

The consultant said afterwards - when I challenged why the hell they think it's ok not to even offer Entonox - that hysteroscopy used to only be done under GA.

If you have any trauma I'd seriously consider going for GA.

I'm quite cross about it. If there were men having their testicles squashed and squeezed and biopsied they would offer lots of pain relief. Lots.

Whatever you decide, I wish you well x

I had my hysteroscopy under a spinal, didn't fell a thing and recovery much quicker than a general. Could be an option ?

@123anotherday I literally had no idea that I'd have to up the progesterone as well - not a clue! I was on 200mg of Utrogestan every day for the last two weeks of my cycle and thought that was enough. That's good to know that you don't have to stop HRT - I'm still off it and the night sweats are back with a vengeance.

Thanks @CrotchetyQuaver! I really hope it's that. I honestly can't wait to be out the other side of menopause - it's all such a pain. Glad it resolved itself for you.

Thank you for your honesty @ooooohnoooooo! That's exactly the info I need. I hate going into stuff blind and being told 'oh it'll be fine' by medics as I really don't trust them any more after a horrendous sweep and traumatic childbirth. I had a call with Gynae Oncology today where, once again, I stated that I would need pain relief because of my circumstances and was told that the Consultant will discuss it with me on the day. I have availed everyone of my need for pain relief so will be really angry if it's not taken into account. I don't want to waste their or my time.

@gfedcba I'd love a spinal. I'll bloody take anything to be fair. I'm just annoyed that I'm trying to put something in place and everyone I've spoken to is very non-committal, see what's offered on the day.

i wish they had offered me the spinal approach but alas it wasn't an option.

please don't feel pressured on the day to do anything you don't want to do. you have given them fair warning!

When I had my first hysteroscopy, I had to go to the appointment and basically was encouraged to try it without any pain relief. They said a local wouldn’t have any effect. To be honest I was traumatised by the experience. When I had more problems about six months later, I really didn’t want to put myself through it again and the gynaecologist encouraged me to have a GA. My local hospital was intent on me trying it without a general, and insisted I came to the appointment to discuss it rather than going straight for a general the first time. The whole thing the first time was barbaric. Most more pleasant experience the second time with a general. I feel it is a money saving exercise.

I had the procedure done a few weeks ago and had a polyp removed at the same time, without painkillers or anything else and it was ok it was just like mild cramping, I had slight thickening of the lining, and they found a cyst, they also took some blood tests, just waiting on the biopsy results coming back.

Thanks @ooooohnoooooo I'm aiming to hold fast and not be pressured into doing something I'm not comfortable with. Yes, they've definitely had fair warning!

I'm so sorry that was the case@Asparename. I think you're right - it very much feels like a money saving exercise because we're just women and who cares about them?

I'm so glad the procedure wasn't too awful for you @Thegoodbadandugly. Crossing everything for your results xx

Update: huge thanks to all you wonderful women who shared their experiences and gave me good advice. Had the hysteroscopy today and consultant and nurses were brilliant. Really calm and helpful. Immediately gave me a local anaesthetic. It was uncomfortable but not too bad - I didn’t swear or punch and I had a little cry at the end because I was so grateful that it was done with such care. Good news is the consultant says womb thickness has gone back to normal so he isn’t too worried. He thinks it was the HRT. Biopsy results back in a few weeks. Hope everyone else waiting for results also got good news xxx

That's good news, OP.