What ON EARTH is happening here? Cancer? Menopause? Fibroids?

[mmm1234]

I’m 53 and have had a Mirena coil in for well over ten years. Originally got it for heavy periods and it’s worked beautifully. About 5 years ago I had a heavy bleed and went to GP about getting it changed but never got round to it as didn’t have more bleeding after and marriage is sexless anyway. Since then I’ve had a few longish spells of no periods or spotting at all, though no other menopause symptoms (except massive uptick in desire for sex) (kind of awkward given sexless state of marriage mentioned above) (DH has done his best with this, bless him).

So about 3 weeks ago I had some pink spotting. All my googling (not recommended!) made a big deal of spotting after menopause, so I saw GP. He put me into the NHS two week protocol for possible cancer. I had just had my callup for my routine smear test.

The pink spotting stopped after about 7-8 days, then I had my hospital appointment. Scan and examination. I’ve got a small (like a good sized grape) ovarian cyst and my uterine lining is 8mm, not too bad but in post menopause they expect 4mm. Doctor took out my Mirena and tried to do a biopsy but couldn’t reach my cervix (severely “tipped”).

I had mild spotting for a day or two and now am in day 2 of really quite a lot of bright red bleeding. No clots. So I’m thinking it’s coming off my cervix not my uterus as it’s so bright and it’s more watery than period blood.

Day after tomorrow I’m having hysteroscopy, cervix biopsy and new Mirena fitted.

What can cause a lot of bright red bleeding post Mirena removal in a 53 yo woman? I go through massive swings from “right, I’ve got cancer, how can I make sure my DH and 3 DDs are ok when I’m gone” to “meh I guess I’m not even menopausal then” to “if I lose all my hair I’ll wear funky hats and let it grow in grey and stop colouring it” etc. It’s been a pretty horrible month, really.

Anyone got any experience to share?

I know you are worried but at the same time, you're maybe over-thinking this.

What can cause a lot of bright red bleeding post Mirena removal in a 53 yo woman?

A normal period. Possibly triggered by the physical action of taking out the Mirena, for a start.

You don't actually know you are post menopause.

From what you have said, it's not clear if you have gone a full 12 months with no period at all (because the Mirena wouldn't be working anyway after 5 years to affect the lining.)

To be post menopause and need all the investigations you've got lined up, the rule is 12 months with no bleeding at all. You can easily go 11 months then spot again or have a heavy bleed, and have to start counting all over again to reach the 12 month stage.

There is no point over-thinking the type of blood etc etc. This can change in peri menopause.

Your dr maybe should have done some blood tests to test for menopause. They aren't recommended for women your age usually as they aren't that accurate but in light of your bleed it's worth it.

It seems a bit over-kill to do a cervical biopsy- are you sure it's not a biopsy of the uterine lining? They would only do a biopsy of your cervix if they saw something wrong with a smear and they'd look at your cervix carefully beforehand before doing a biopsy.
If it was bleeding to the extent you think it is, this would show simply by looking at it.

FWIW I've had a hysteroscopy and 2 biopsies after 2-3 episodes of spotting around age 53-54 but I was (and am) using HRT so it was never clear if it was the HRT or my own hormones causing the spotting.

My money is on all of this being normal peri meno and your periods aren't finished yet.

Is biopsy of cervix a horrible thing to have done? Pretty sure that’s what they said they will do. It’s being hurried along because I’m going away on Saturday and I think they need to hit targets because the GP put me into the two week protocol. I’ve seen things on here that I didn’t know were menopause symptoms that I have had like bad memory and interrupted sleep and although not hot flushes, just being generally warm at night.

Ugh I can’t wait to just know either way and start feeling able to relax and enjoy life again..

How long after your hysteroscopies did you get results / feedback, JHB? And also I’m supposed to be going out for dinner on the evening of the day I’m having it (tomorrow) - will I be up for it, do you think?

Btw JHB thank you for reassurance, I wish I’d found all you people a few weeks ago 😰

who told you it was a biopsy of your cervix?
Are you sure they didn't say they would take a biopsy during the hysteroscopy? (Which is normal procedure.)

A biopsy of the cervix is usually only done during a colposcopy (look that up!) and it's a different thing. It's only done if you have had a dodgy smear- they use a special magnifying glass to look at the suspicious area and take a biopsy.

Maybe you misunderstood?

I got my results back in around a week but this was a private appt using medical insurance. Don't know how long NHS.

You should be fine to go out to dinner but maybe take a couple of ibuprofen shortly before the procedure and afterwards too? sometimes you get slight crampy period type pains for a couple of hours and slight spotting.

Thank you. I did feel sure it was a biopsy of cervix but now I’m not sure any more. Btw will they mind that I’m bleeding quite a lot, will it affect the procedure? I had the plan of taking it easy today and not going on the standard 6km dog walk so sat on the sofa while DH did it and then when I got up to let them in I flooded the towel so much I felt like I was having a wee! (TMI, sorry...)

Btw we have private health but GP said it’s just as quick on NHS for where I am in the process, so we haven’t used it.

They can still do the procedure but it might be harder for them I assume to see the lining clearly if you are bleeding- but I'm not sure on that. You need to call the hospital.

The benefit of having it done privately is you can choose the day / time, get the results quicker, and it's just a bit more pleasant in the surroundings and the drs have a bit more time.

It will be a biopsy of the lining- this is to check that the cells are normal.
Highly unlikely it's a cervical biopsy if you have not had an abnormal smear result.

Thank you. I’ll let you know tomorrow! Bleeding has eased off a little this evening even though I have been fairly active with cooking dinner etc

Yes JHB you were right. Biopsy of uterus lining I think. Home already and lying on sofa. Bleeding again 🙄

Ah okay! Hope all is okay and you feel better.

Thank you! Feel pretty ropey and still a shadow of worry about possible results of course. Also looking forward to not bleeding sometime!

Would I have had a tube down my throat do you think? It’s quite sore!