I had unexpected bleeding for about 4 weeks post menopause (I think)

[oldandscunnered]

Basically I have had the mirena coil in for years, well it turns out this last one is 11 years so I have obviously gone through the menopause. I was put on hrt last year, I think mainly for low mood. Anyway I had bleeding for about 4 weeks. Went to the Dr. over 3 weeks ago and she put in an urgent request for me to be seen in 2 weeks. Still no appt through. I have not bled for about 10 days after stopping the hrt. Do I still need to go for the appt?

You absolutely do need to go.

Yes you definitely need to go. Chances are its nothing to be worried about, but its definitely a symptom that shouldnt be ignored.

I had bleeding last year and was also put on the 2 week pathway. I saw a Gynae who couldnt locate what was causing the bleeding.

I was given a smear - which was all-clear.

I was then sent for a scan which identified two cysts. I had briefly been on HRT for only a couple of months (i didnt like it and stopped). Apparently this could have caused the cysts. It is thought the cysts caused the bleeding.

At the time i worked myself up into a right state, convinced i had cancer. The gynae i saw was fantastic, she explained that bleeding isnt something that should be ignored, but, in the majority of cases is usually nothing serious.

Thanks for your replies - I have been on the hrt for about a year with no issues but I will definitely go to the clinic, if I ever get an appt through. I was really anxious to start with but as time goes by I'm getting less worried. Hopefully it's nothing.

You still need the appt, yes.

BUT- Not enough info in your posts :)

I'm unclear what has happened @oldandscunnered

How old are you?

Being on the Mirena for a long time doesn't mean you are post meno. You might be, or maybe not.

Did you have ONE Mirena in for 11 years? Never changed?
well it turns out this last one is 11 years

And no bleeding at all for all those years?

And what type of HRT are you using?

You could still not be fully menopausal, although if you have had bleeding for 4 weeks, it needs looking at.

Sorry, I m 56, the last coil has been in for 11 years and no, no bleeding until this episode, so can only assume I have been through menopause while the coil was still working and have not been aware of it. Only symptoms really were sore ankles and knees and vaginal dryness, and low mood. No hut flushes or anything like that. Last period was probably when I was about 40 because I've had the coil in for many years.

@oldandscunnered

Sorry, I m 56, the last coil has been in for 11 years and no, no bleeding until this episode, so can only assume I have been through menopause while the coil was still working and have not been aware of it. Only symptoms really were sore ankles and knees and vaginal dryness, and low mood. No hut flushes or anything like that. Last period was probably when I was about 40 because I've had the coil in for many years.

If you see this @oldandscunnered...what hrt are you on?

I am wondering if the hrt is JUST estrogen? That would account for the bleeding. The Mirena is used as the progesterone part of HRT but it loses its hormone after 4 years, so for 7 years it would be 'just' a coil and not releasing progesterone into your uterus.

What HRT were you on?

The coil was in for years??
I thought it had a shelf life of 4/5 years?
It is the progesterone element of your HRT?
Perhaps your lining has thickened and shed?
Definitely push for a scan.

Best of luck.

I was on 2mg ellest duet. The coil wasn't doing anything - because of covid they said I could get it taken out at my next smear test. Finally got my appt for 24th March, which will be six weeks since I saw the Dr.

Have you been sent for an ultrasound OP?

Op, I am similar. My mirena has been in for 13 years. Since 2009.

For the first few years I only had a bit of spotting till 2019, had two separate slightly more blood episodes one in Apr one in Nov then nothing. I went on conti patches in Oct 20 for a range of symptoms including va. First few days Jan 22 started spotting with some tiny clots, lasted a week. Then again in Feb and this month as well.

I had read that mirena is licensed for at least 10 years and is functional for that time in Europe, its only here in UK they replace after 5 years.

All my smears are clear and internal scans clear in 2020.

My levels of estrogen were low before hrt and my thinking is they have got built up now and have kick started my ovaries into working again.

I could be totally wrong. I would be interested in hearing how you get on Op.

@Tootsey11 The Mirena is licensed as contraception (in older women) for up to 10 years although the progestogen it releases only lasts for a few years. After that time it works mainly like a copper coil.

When the Mirena is used as the progestogen part of HRT, it needs replacing every 4 years or (5 years off licence.)

Estrogen doesn't kick start ovaries. Ovaries run out of eggs and that's menopause.

@JinglingHellsBells I had the mirena put in to control endometriosis at 34. I didn't need it for contraception.

I'm 47 now, and after no bleeding or spotting, nothing since 2019, I am now spotting/slight bleeding regularly at the start of each month since the start of the year.

I've never had regular bleeding in my life. They have always come when they felt like it.

I've been on conti patches, these have both estrogen and progesterone since Oct 20.

If you are still spotting after 6 months on continuous combined hrt, it needs investigating. (That is the Rule!)

First step is a ultrasound scan. Then possibly a biopsy, then perhaps hysteroscopy and biopsy.

However at 47 it's likely you are not yet post meno, so the bleeding is actually your own period.

Why were you put on conti at 47?

Is this because of endo?

I'm not sure why you are not getting what I'm saying. I was put on conti because I was clear of any bleeding for over a year. That is what they are supposed to put you on. I was put on conti in Oct 2020. All was fine on the conti, no bleeding no spotting nothing, zero for 15 months then the spotting started regularly at the start of each month of 2022. So Jan for a week then Feb for a week and now March for a week.

I believe I am post menopause. In my late teens and twenties I had 2 or 3 periods a month.