No HRT till Cervical Polyp is removed 1st

[SayyestotheDog]

Is this standard UK NHS practice or is the GP being overly cautious?

Cervical polyp was found at my last smear - no action/monitoring (bar smears) was recommended at the time.

Smear was negative & on a routine repeat.

I happened to mention the polyp at my HRT appt & the GP said it needs to come off (& biopsied to rule anything out) before she can prescribe & referred me for a scan as well.

Was impressed GP being so thorough (as have had precancerous treatment in the past - last fewsmears have been negative however). But I didn’t raise this or the damned polyp as a matter of concern particularly & more just in passing.

So my appt for the polyp has come through…but it’s A WHOLE YEAR AWAY!!

I actually turned up at hospital today & was in shock when they said it’s for today but in 2024!!!

I’m in Perimenopause & really can’t wait that long.
Am struggling mainly with horrific anxiety, rage & worsening MH (which I already take medication for).

Other than seeing a different GP or going private what else can I do?
The option of choice wasn’t given so doubt would get a quicker appointment at a different location/hospital.

And given the state the NHS is in I appreciate a polyp is hardly high priority so am not expecting front of the queue treatment.

Given my history I appreciate the GP’s caution but is she being excessive?

Anyone been in a similar position or got any thoughts? I’m in the UK btw.

Thanks!

Is this standard UK NHS practice or is the GP being overly cautious?

Not over cautious but badly informed IMO.

No connection between a polyp and being able to use HRT.

See another GP or a private gynae if you can stretch to that.

I had a polyp out. From dr appt to removal was 3 weeks. And saw a sonogram get person in between. I would bang on to the dr about getting an earlier appt. And call the hospital regularly to see if there are any cancellations. Good luck

@JinglingSpringbells thanks - I will try a different GP I think. Maybe it’s just more evidence of the lack of knowledge or expertise in menopause care in general.
Fingers crossed 🤞

@user1494050295 that’s a good idea about trying the hospital direct for any cancellations.

Did you have yours done recently? I think with Covid & everything else waiting times are particularly bad ATM. Maybe I hadn’t realised just how bad….

I have a cervical polyp & I’m on HRT.

I’ve had the polyp for over 20 years.

I had lots of bleeding on hrt so had a hysterectomy. They found the cervical polyp and removed it then in no time at all. A year sounds extraordinary.

@ArtVandalay that’s interesting. The nurse who did my smear was very laid back about it in that they’d just monitor it at smears.
But maybe my precancerous history means it needs to come off….

Maybe I should check with the hospital bookings in case it’s an error - although the reception staff confirmed that that particular consultant hasn’t got any space on her list for a whole year.

I’m definitely going to investigate now - thanks for the replies.

Last post was for @MyNameIsErinQuin

A nurse did mine! Not a doctor in sight!

Wow - you can’t get quicker than that! @MyNameIsErinQuin

may 2019. Also the pct has low waiting times. Sw London. Good luck

I had a polyp removed within three days. My doctor treated any cervical change as urgent. I've never had any problems with my cervix and the polyp was benign, as most are. I'm surprised doctors are leaving them. It was so simple to remove it.

This was in December 2020. Colposcopy done at the same time, so good reassurance all is in good order.

I'd say there are 2 different issues here

1 How big is the polyp, is it causing bleeding, and should it be removed quickly?

2 Is HRT going to increase the risk of whatever is going on with the polyp?

Answer to 2 is probably no- keep using HRT.

Cervical polyps are usually removed if they bleed as they can do, or if they bleed during sex. If they cover the opening of the cervix then they might also be removed as they can make it harder for blood to come out during periods.

That interesting. Mine didn't bleed or cause any issues. I only knew it was there because the doctor found it during a routine Pap test. Still removed.

Hi again thanks for the replies - it seems from everyone’s experience that it depends on lots of factors, like size, location etc & ultimately the person you see on the day & what their individual approach & practise is & then what PCT/HA you’re in & wait times etc.

In my case the nurse said it wasn’t particularly big & it isn’t causing bleeding between perimeno (so fewer & far between) periods.

Apart from the size it seems that some can be located higher up in the cervix & so can’t be removed there & then at your smear. And it may be that they can’t get a good enough view of mine as I have a retroverted cervix (if that’s the correct term).

It’s also possible that what I’ve thought has been a light “period” could well have been caused by the polyp & not my cycle after all?

Which could make it harder to know if when I eventually start HRT if it’s that or again the polyp causing any other bleeding.

So it’s probably best it comes off - the issue then is the waiting time. Having looked at similar threads on here in Health however it seems that 12 month wait ATM is not unfortunately that unusual.

And when they are finally seen - it’s just for an initial check & they are then put on a further 6-12 month wait for the actual removal.

I could afford a private consult & possibly removal (depending on cost) - but does anyone know if worst case scenario (which I doubt) it is not benign - how you would then be eligible for NHS care - as I would not be able to afford private?

That sounds a bit naive I presume a referral could be made - I’m probably being thrown by the difficulty in getting some GPs (mine among them) being uncomfortable sharing care with private providers for ADHD & MH related care (where I appreciate risk management & prescribing /supervision of off label meds are the main issue).

It’s a minefield!

Not wanting to be too graphic….. Mine caused a tsunami of a bleed so I was referred under 2 week wait for a hysterscopy. The nurse found it straight away and then it was gone.

I could afford a private consult & possibly removal (depending on cost) - but does anyone know if worst case scenario (which I doubt) it is not benign - how you would then be eligible for NHS care - as I would not be able to afford private?

I can't give you the specific costs but you would need to see a private gynae first who'd take a look. What happens after that all depends on how big it is and if they can just snip it off very easily, therefore no other appt, but you'd have to pay for the testing of it.

The first appts are usually around £250.

If it wasn't benign you'd just go straight back into the NHS for treatment.

A hysteroscopy is a camera into the womb. It's not used for a polyp on the cervix which can be seen. Surgery is usually done by a consultant for removal of polyps.

@SayyestotheDog Most consultants these days take direct referrals. You don't need a GP referral. You make the appt through the consultant's PA/ website etc.

Thanks again all.

Ok @JinglingSpringbells that’s good to know I cld be treated in NHS if need be after private biopsy.

@MyNameIsErinQuin glad they were able to deal with it so quickly.

I’m also really confused about how you ever move from cyclical to continuous HRT if your periods are v irregular anyway & may have been caused by a polyp over the last year & not your cycle??

Too many questions!