Bleeding during sex

[Sssudio]

I've been having spotting during sex for a few months now, I put it down to atrophy (and I'm sure some of it was).

Last night though I properly bled afterwards, to the extent I'm on holiday and having to wash all the bedding and mattress cover today. I've also had a period over 10 days early and am currently waiting for an ablation and biopsy due to bleeding.

Is this just menopause or does it need the GP? And what will they likely do?

I am currently under the hospital after having melanoma surgery and am due to have more suspect moles removed so my own judgement is skewed.

I'm 48 and on 100mg oestrogen patches and 12 days vaginal progestérone

Yes GP asap

I've also just had an HPV screen that was fine but did have a polyp removed (7 weeks ago).

Bugger

You need to see your GP but if you aren't post menopausal yet, it's not likely to be anything serious- more likely hormonal and a blip with all of that.

The most obvious thing is that you aren't using enough Utrogestan.
There was new guidance out some months ago which advised using up to 200mgs of Utrogestan daily for women on high dose estrogen- which you are.

What may be going on is that at 48 you still have your own estrogen circulating, your own periods may not have stopped yet, and the amount of Utrogestan you're using isn't controlling your own cycle.

Your GP might suggest you do 14 days of Utrogestan, and reduce the patch to 75 or 50mcgs.

I had this at 40 - for me it was cervical atrophy. It’s when the surface of the cervix changes due to hormonal changes. I had cauterisation as a day patient and it’s never happened again.

cervical atrophy

It's called cervical erosion and that's not the same as atrophy.

Thanks, I'm bleeding heavily still every month and using 200mg utrogestan for 12 days a cycle, I upped my patches about 3 weeks ago to 100mg from 75 as a lot of my symptoms that had gone were creeping back.

The random early bleed recently was before I'd even started on that cycle's utrogestan (and was only on 75mg at that time).

If it wasn't for the insomnia/aching joints and suicidal/homicidal mood swings I'd just come off the HRT but it's been life changing and having it removed is a real fear

I also had cervical erosion which caused post coital bleeding. It was cauterised and never bothered me again.

Thanks, I'm bleeding heavily still every month and using 200mg utrogestan for 12 days a cycle,

Well, that's normal because you are on a sequential regime.

You should probably use it for 14 days on that dose of estrogen. That might lessen the bleed a bit.

TBH depending where you are in peri menopause (and how long you have used HRT) this unexpected period is probably just your own period coming out of sync with the HRT cycle.

If you think the spotting is vaginal atrophy you could ask for vaginal estrogen.
You say you are up to date with smears- and the polyp was a cervical polyp, was it?

Yes, polyp is assumed benign as no recall and I'm also on vaginal oestrogen.

I'll raise an online form for the GP when I'm back and let them decide, as I'm already on the v long gynae waiting list they may just ask them if they want to see me sooner.

already on the v long gynae waiting list they may just ask them if they want to see me sooner.

I didn't appreciate you were waiting for a gynae appt- what's that for?

Ablation and biopsy for heavy bleeding, had bleeding before kids, resolved for years and then started again the past few years. Haven't seen gynae only spoke on phone and they put me on the list