Yet another post menopause bleed

[Faddd]

Possibly this is more of a whinge than asking for advice. Or maybe someone has had similar issues and can comment?

I am post-menopausal and on HRT, I haven't had periods for nearly 4 years. Except, every covid jab I had brought on a period (I know Im not alone in this) and when I actually had covid I had a period then too. So given that was about 5 periods over 10 or so months I was sent for investigations including an internal ultrasound All ok. Forward a year, and I had another 3 periods (I had been ill for several months funnily enough) so I was investigated again, had another ultrasound and then after that a hysteroscopy, which was a bit ouch quite frankly. Another year-ish has passed and guess what, Im having another sodding period. Do I really have to tell the GP? I know she'll refer me again?? I just have a vision of having annual hysteroscopies for years!! 😫

I'm in the same boat, except its only 6 months since my previous one.

Have you tried changing your progesterone? I was put on 200 then 300 daily Utrogestan which didn't work. I'm now on 20mg daily of Provera which worked for 6 months.

I'm so fed up with it.

Go and see your GP asap! It could be very serious.
When I had post menopause bleeding even though the first look didn't look like anything the biopsy showed cancer.
I would anyway push for a hysterectomy (preferably robotic) just in case

@Movinghouseatlast That's interesting, I didnt actually know that you could change your progesterone dose, just seems to come in a set dose (one tablet!) I've only ever been advised to tweak the oestrogen. Im now on the max of that! I'll ask about the progesterone, thanks

@MollyButton Oh no, hope you're ok now. I will see the GP, I know it's not to be ignored, its just such a drag. But not as much as cancer is, lets face it.

I had this, bleeding after covid and the vaccinations, and then another non-covid period. Had already had one hysteroscopy for a bleed 18 months after my last period, when I was on combined oral HRT. All fine. Changed to gel/oral progesterone. Had my second under general otherwise I wouldn't have done it. Had a Mirena coil fitted at the same time.

Once the initial spotting settled I've had no bleeding. Would recommend. Utrogestan gave me horrible side effects.

Edited to be clearer - both were all fine, changed from oral to gel/utrogestan after first hysteroscopy, coil at second.

I'm fine thanks found very very early. And treated brilliantly.
But my mother on the other hand had put off seeing the doctor and whatever she had killed her before she was my age.

Starting, increasing or changing systemic HRT can cause bleeding in the first few months. If anything else has been ruled out as the cause e.g. polyps, usually the progestogen component can be changed to stop the bleeding. You could also try reducing your oestrogen as long as it still controls your general menopause symptoms

I’ve attached guidelines here. - see page 6 https://thebms.org.uk/wp-content/uploads/2021/10/14-BMS-TfC-Progestogens-and-endometrial-protection-01H.pdf

@over50andfab Thanks for the link, I'll have a good read of that. I was going to say that nothing has changed recently in terms of my HRT regime, but thinking about it, that's not so true. About 8 months ago I was having awful sweats and given I was already on 4 pumps of oestrogel, the GP told me there wasn't anything more he could do. I paid for a private oestrogen test and it turned out my levels were rock bottom, actually post - menopausal - I hadn't been absorbing the oestrogen. I went onto patches (Estradot 100) and the sweats have gone, so presumably my oestrogen levels are better now. I have been on utrogestan 100 all this time....do I need a higher dose now my oestrogen is higher? Was it the low oestrogen/high progesterone combo previously that may have contributed to the other bleeds I had? I think I need to do some research, so thanks again for the link.

You should try 200mg of oestrogen in the first instance which may stop the bleeding.

You have had investigations but it seems thst nobody has suggested a solution to it

If you weren’t absorbing the gel at all going straight to 100 patch which is the max approved dose might have caused bleeding in the first few months. You must be absorbing the estradiol in the patch if it’s controlling your symptoms (it might even be that you don’t need as high a dose)

Some women are automatically advised to double their Utrogestan when on the maximum approved dose by their doctor to control the womb lining. The link mentions this, though there are no specific guidelines on at what point this should be done. Persistent bleeding with no cause found would be an indicator to do this as Movinghouse mentioned.

if you’re in the UK, suggest you show the link to your doctor and discuss your options

Hello newbie here I went to see GP last week as I had my ovaries and tubes out last year, well me and my bf got together and I spotted afterwards, she did internal examination and said I will refer you to see gynaecologist then same day I got a call saying you’ve been referred two week wait!! I looked on my patient summary it says probably cancer! I’m terrified, I had vaginal scan before operation last year, no bleeding since, up to date with smears why didn’t go tell me in her room xx

@Dolly41 it's really frightening when you see the "two week suspected cancer" referral letter. I've had a number of them in recent years for different things and have never been diagnosed with cancer. Was advised by gynae that it's to rule it out rather than in and relative to the number of people she examines there are very few who actually have cancer.

Hope everything is ok for you

Thank you, firstly she said you will receive a letter should be in 4 weeks, then got phone call when I got home, no mention of cancer in her room, why state it on my patient summary xx