Unexplained bleeding

[Mishmashmarshy]

I am currently on continuous HRT and have been since November. I was told it might take a while to settle down so I ignored the first couple of bleeds. When it happened a third time I spoke to my GP. I have had a scan and I am now waiting for an appointment to have a biopsy. I am in pain and the blood is bright red - no idea if that is a good or bad sign. How worried should I be? Does anyone have experience of this?

I’m shamelessly bumping again in case anyone has any advice or experience. I have had a couple of referrals but as yet no appointment which is causing me such stress.

Please don't worry. This sounds normal for conti HRT. The guidance says that you can expect bleeding within the first 6 months. Nov- mid-May is only just over 6 months.

What stage of menopause are you at now?

Presumably if you are on conti, you had not had a period for at least 12 months previously, OR you are older (54) and it's assumed your periods had stopped or were very far apart.

If this is not 'you' then you have been given conti too early and the bleeding is your own period which is overriding the HRT.

Thank you so much for responding. I am over 55 and it was believed that my periods must have stopped. I suggested to my GP that it might be my cycle breaking through but she said at my age she thought it unlikely. I have had about four bleeds now the most recent lasted about 2 weeks. I also have a thickened womb lining which has got thicker whilst I’ve been on continuous HRT. I have almost constant pelvic discomfort which feels like period pains.

I know it's worrying but the chances are it's all hormonal.

When you said it was 'believed' your periods had stopped, do you not know yourself how long ago the last one was? Is there a reason you can't tell?

Has your dr explained what happens with conti HRT? Estrogen makes the lining thicker but the progesterone keeps it in check so it doesn't bleed. It can take some months for this to be a perfect balance.

If you still have some of your own estrogen, that will prevent the balance in conti from working.

What type of HRT are you on?

I also have a thickened womb lining which has got thicker whilst I’ve been on continuous HRT.

Can you explain this? How do you know your womb lining was thick before you started HRT? Had you already had a scan for some reason?

How do you know it's now thicker? (presumably compared with a previous can?)

If the biopsy shows everything is normal, the next step is to change your HRT to one type where there is more progesterone to control the estrogen. The Mirena coil is brilliant and you'd just need estrogen as a patch/gel with it.

Thank you that is all reassuring.
I’ve no real idea when my last period was - I don’t know how people tell once they start HRT.
I use Oestrogel and Utrogestan. I had a scan before starting conti HRT and apparently the womb lining was slightly thickened but not a concern. The fact that it has got thicker whilst on the conti HRT does seem to be concerning my GP. He did mention cancer. The fact that I am still waiting to be seen makes me think there is probably not too much too worry about but the waiting is starting to make me anxious. I just want to know it’s all okay.

So you'd not had a full 12 months with no period when you started conti HRT? As far as you can tell? That's actually really important.

Why did they scan you before starting hrt? (This isn't normal to do that.)

Just for info, I went through something similar some years back when first starting hrt but it was sequential (and still is as I felt rotten on conti.) I had spotting in between hrt 'cycles' and was convinced it was my own hormones.

How much gel and how much Utrogestan are you using? Are you taking 100mg Utrogestan every day?

If you had not reached post meno before using hrt, then yes, your own lining could be thicker, as the lining could be building up. That's quite normal for peri and why some women get flooding once a period comes after months without one.

Your dr's doing the right thing, to check it out, but it would be quite 'unusual' to develop cancer so quickly.

I’m really embarrassed about this but for a few months I only used Oestrogel. It was impossible to get a doctors appointment and Utrogestan was not on my repeat prescriptions. This is why they insisted on the initial scan. I didn’t understand then the importance of the progesterone.
I don’t know if I’ve have had an actual period in the last 12 months just withdrawal bleeds. Sorry. I know I sound clueless.
Yes I am taking 100mg Utrogestan every day.

Ah I see. So before November, you used only Estrogel for a few months on its own? (Or you used it on its own since November for a while?)
Sorry I don't want to appear nosy and I know you are really worried as I was when I had spotting.
I've used that combination for years which is why I'm querying it, just to see if I can help.
The point is, your GP ought to have made sure you had not had a period for 12 months or more before offering you conti. If not, then you can get this odd bleeding.
If you used only estrogen for some months because you had run out of Utrogestan then yes, the lining would become thick and using only 100mgs of Utrogestan now is probably not quite enough to reduce it.

I am not a dr but from what I know, it would have been sensible for your dr to suggest you had a cycle (using Utrogestan 200mgs) to clear the thickened lining first, before using it as conti. This is because conti is for women whose lining is already thin as they are post-menopause.

Try not to worry and I expect you will have a biopsy soon and all will be okay BUT you might need to use something stronger than 100mg Utrogestan to clear the lining.

Yes I used Oestrogel on it’s own before November. I have taken Utrogestan religiously since. Thank you so much. I feel so much better now. I don’t know anyone who has been through this so such a relief to hear your experience.

Hi
Firstly, thank you ladies for all your information about hrt! I haven’t posted before just read a thousand messages so don’t know if this is how I ask a question about Hrt?

@pepsi You start your own new thread . See the top of the page. start new thread.

Thank you. I can’t seem to find new thread!! I ll keep trying as have questions about starting hrt.