Is abnormal bleeding benign?

[Sssudio]

I've been waiting for an ablation for well over a year after a phone call with gynae during lockdown for extremely heavy and flooding periods(no other treatment options).

I've since started having 3 week cycles plus bleeds after sex, despite being on sequential HRT (100mg oestrogen patches plus 200mg utrogestan vaginally 12 days a month). My GP has referred me more urgently to Gynae but system here is to have investigations first then refer - CA125 was normal and scan showed adenomyosis and a haemorrhagic cyst - hence more urgent referral to gynae.

Gynae list even as urgent is huge, so am waiting on a follow up scan to see if any changes - but GP referred saying urgent in notes but with routine category so it's going to be another 6/8 weeks at least - my first scan was August.

So not to drip feed I've had a horrendous few years health/family wise and have had 3 melanomas removed this year and had a fourth suspect one removed on Friday - so my judgement is skewed.

Despite being 48 and always having 29 day cycles, and starting bleeding now on cycle day 17/18 (as starting the progesterone) can the menopause just do this and make cycles much shorter like this despite the hormones? Or do I need to keep pushing GP (who has said it's between me and hospital, who say I need to go back to GP)?

I am just so so tired of this now, if I know it's not likely to be anything other than annoying menopause I'll save my energy for another battle.

Sorry it's so long, didn't want to miss anything out

My GP has referred me more urgently to Gynae but system here is to have investigations first then refer

Are you in the UK? Because advice can vary between countries or regions.

- CA125 was normal and scan showed adenomyosis and a haemorrhagic cyst -

Was this a transvaginal scan?
Did they do a hysteroscopy and biopsy?

The above is what you'd expect for abnormal bleeding.

The other point is that some time ago- coming up to a year- the British Menopause Society issued a report on the use of progesterone (it's been linked to several times on this part of Mumsnet, by me, if you can search for it.)

Their advice was that for women on a high dose of estrogen (100mcgs patch) they should consider 300mgs of Utorgestan to control bleeding (and 14 days not 12.)

Your GP ought to have read that guidance.

The bleeding you're having is usually too little progesterone to estrogen, either your own estrogen at high peri levels, or HRT estrogen.

Without knowing where you live, it's hard to advise but as a minimum you'd expect a hysteroscopy and biopsy, not just a scan.

It's only by doing a biopsy that anything serious can be ruled out.
This would normally be done within the 2-week guidance.

The usual practice is for a GP to refer you to a gynaecologist who would then arrange the next investigation, depending on how urgent they felt it was.

I don't understand what you mean by it's down to you and the hospital.
Your GP is supposed to refer and chase referrals.

I'm London. I've only had a TV u/s and the bloods so far, since posting the appts person at the hospital rang me back, I think she could tell I'd burst into tears on the previous call so she read my notes and took pity on me and found me an appt for Wednesday. Apparently I've been referred on the urgent but non cancer pathway, which has a massive backlog.

Thanks for the reply though, am hoping hospital can help tweak my HRT as part of this.