Post Menopausal Bleeding

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Four years since I had a period, have now started to pass old clotted blood and blood stained discharge intermittently. GP has referred me to gynae on the two week pathway. She tried to insert a speculum this morning, but vag clamped shut and it was too painful to tolerate. She examined abdomen and found nothing in particular.

I had to have a hysteroscopy a few years ago for an attempted essure placement, but it was too painful and I had to get off the table and ended up going home. I'm really worried about having another hysteroscopy. I've never had vag births and cervix is well and truly closed. I don't have intercourse either. Nothing goes up there as hasn't for years. I was also sexually assaulted as a young girl as well as when I was pregnant and had a membrane sweep that I didn't consent to which was extremely painful.

Am I able to ask for a GA, or can they refuse to treat me if I refuse a waking hysteroscopy? What should I say? I expect them to say I'll be stuck on a waiting list if I insist on a GA. Is this reasonable or should I expect examination within a few weeks?

I had a hysteroscopy last year under GA, due to extreme stress with having various gynae procedures. The stress got worse over a period of time, despite having had numerous coils fitted when I was younger without any issues at all. My GP had referred me to a gynae and it was done a couple of months later. I'm post meno too.

Yes you can ask for a GA for any reason. You should get a date quickly if you're on the 2ww pathway.

Insist on a GA hysteroscopy, they will need to take biopsies which means a slightly bigger instrument. Explain that you experienced vaginismus when you were examined by the GP.

Thanks. Did they make a fuss or was it okay? I'm primed to be compliant, but really can't face this without a GA. Were your results okay in the end?

OP, they shouldn't cause problems if you ask for a GA. It's common for women who haven't had vaginal births (and some who have) to need it under GA. There are plenty of women who tolerate it fine as an outpatient but also some that don't for a variety of reasons.

We do 6 or 7 a week at my hospital under GA

I had a hysteroscopy under GA last year for post menopausal bleeding. I'd had a previous hysteroscopy without anaesthesia and it was beyond horrific. I refused to have another one without GA. It wasn't a problem and no one tried to convince me to just proceed. I waited about 8 weeks for it (also referred on 2 wk pathway)

I’ve had a hysteroscopy without pain relief and will never agree to it again.

It was very straightforward. I'd already been referred to a gynae previously at the local hospital so she knew me and had seen the state I got into trying to do everything without GA. So she booked me in and was very kind and helpful about it. I also had a coil inserted (for HRT purposes) at the same time, this didn't work out and I wanted it taken out pretty soon afterwards. Interestingly, the GP practice (I'd been discharged from the gynae by then) didn't seem to want me to go back to hospital and booked me to have it taken out in the surgery. The GP did it and it was really quick and completely painless! It just goes to show how different it can be with different people doing the procedure and in a less stressful situation.

BTW my results were all fine, thank goodness.

I'd get back onto your gynae and ask for a GA asap and get it over and done with. The longer you end up waiting for these things, the worse it gets.