Period after 2 years post menopause?

[OneWildBiscuit]

Bit of an odd one.

I've been post- menopausal for over 2 years with no spotting or bleeding in that time. I've been on Evorel Conti patches for the past year or so, which have been a Godsend.

Randomly, over the past week, I've noticed the stringy egg-white type discharge I used to get when ovulating, and a couple of days ago had the old familiar lower abdominal pain and diarrhoea I always used to experience just before a period. I woke this morning to find I'm having a very heavy period 😕.

Should I be worried? Has anyone else experienced anything similar?

Like most of us, I struggle to get a GP appointment, and work Monday - Friday 9-5 which further complicates things.

Should I be pushing for an appointment?

Yes. Post menopausal bleeding (anything over 12 months from your last period) is taken seriously. Probably nothing to worry about but they'll see you quickly

Thanks. I'll try to call tomorrow and hope I can tan appointment.

Agree, hopefully it's nothing. Could be thickness of the lining of the womb or fibroids.

It's probably thst you need more or a different progesterone. Or fibroids. So don't worry but yes you need it checked out.

I was swapped first to Evorel plus Utrogrstan, then Utrogestan was increased then put on Provera. They finally discovered a huge fibroid.

See your GP tomorrow. You will probably be out on the 2 week pathway to be thoroughly checked out.

It may well be nothing but it can also be a symptom of cervical cancer. That has very positive outcomes if dealt with swiftly, so it’s always worth checking immediately.

@OneWildBiscuit I read something online recently on guidance for investigations for this.

It said that for women on HRT the 2-week pathway isn't so necessary because the risk of endo cancer is very low compared to women not on HRT, who have bleeding.

I think it said that an appt within 6 weeks was acceptable.

It also depends a little bit on your age.
In younger women (45-50ish) the ovaries can push out more eggs, compared to women who are 55 and older.

But do see your GP.

You do need to get any post-menopausal bleeds checked to rule out other health conditions. However, I think your ovulation symptoms should give you a bit of peace of mind that it's nothing sinister.

I have an older colleague that kept having a very stop/starty menopause. From earlier 50s she kept going around 18 months with no periods then they'd start up again and she was put on the ovarian cancer 2 week wait but it was nothing like that. A combination of fibroids and much higher than average ovarian reserve (at 56/7) - her GP said she should be very careful to avoid pregnancy!

^ this

I had similar recently and my GP saw me quickly and I had an ultrasound at the hospital at the post-menopausal bleed clinic. I was fine, but they adjusted my patches.

Same here (scan at 8.15 this morning, actually - yes, a Sunday, well done NHS!)

All fine on scan. I think my progesterone prescription wasn’t set high enough, doctor has doubled it.

Needs checking though, as others have said.

Thank you all...I feel a bit more reassured now. I'll call my GP tomorrow and hopefully get an appointment. 🙂

Mine was 20 years post menopausal. GP said it was very likely the hrt causing the endo to thicken. I was diagnosed with fibroids in my 20s, they shrink with the meno, but can enlarge with HRT. I had a colposcopy with biopsies and all was fine.

I had post-meno bleeding 10 days ago and am still waiting for my docs appt, it's not till next week!
where I am, there's a self referral service where you fill in an online form with details and that decides if you need to be seen urgently or not. Presume because I'm on HRT and have no family history of cancer that decided it was not urgent. So don't be too alarmed if you are not seen immediately, it seems there must be new guidelines.

There is new guidance, some of which suggests stopping HRT for 6 weeks to see if the bleeding stops. This isn't altogether helpful as many women suffer badly when they stop. I think it's a cost-saving exercise partly because the risks are so low when women on hrt have odd bleeding.

Similar for me...I've got an appointment in 10 days so they obviously don't think I need seen immediately.

I hope they don't suggest that...HRT has been a lifesaver! 😕

I had post menopausal bleeding in July. I was seen in that day by a physician assistant who did an internal examination and referred me to the hospital on the 2 week pathway. It took about 4 weeks in the end. I had a scan at the hospital - trans vaginal and over the top plus another internal examination where they attempted to do a biopsy unsuccessfully. I was referred for a hysteroscopy which was done yesterday under general anaesthetic. They removed a polyp and suggested upping my progesterone to 200mg. I should get the biopsy results in a couple of weeks but hopefully all fine. It’s taken about 2 months from start to (hopefully) the end. Amazing NHS service.

I had post menopausal bleeding caused by fibroids which led to a hysterectomy.
Hope all goes well for you and there’s nothing of serious concern.

That's excellent. I hope your biopsy result shows nothing of concern.

My GP has referred me for an urgent ultrasound - she didn't specify when I can expect this, but did say she'd get me on the urgent post menopausal pathway so hopefully will be quite rapid.

I had period pains and sore boobs about 2 months ago then one morning had a really sharp pain in one side near my ovary. There was blood when I wiped after going to the toilet a few times then stopped. The bleeding happened for 3 days then stopped.
The doctor couldn't refer me until I had come off hrt for a month I think.
The second doc I saw nearly 3 weeks ago that I asked to be referred, has not put my referral through 🙄 so I now have to start all over again.
I really need my hrt back too 😫
Op, hope yours is nothing

Try not to worry, as bleeding on HRT is rarely anything serious.

I didn’t have to stop my HRT whilst the investigations were going on.

I think this is a cost-saving move to try to stop so many investigations.
Not all doctors suggest this. It's fairly new guidance within the NHS.

In the majority of cases, if it's an HRT 'hiccup' it might stop when HRT is stopped. But equally, a lot of women will spot or bleed anyway when they stop estrogen. (That's on all the product leaflets- 'if you miss a dose you might bleed'.)

It doesn't seem logical because just because the bleeding might stop when HRT is stopped for 6 weeks, that doesn't prove there is nothing else going on.

The old guidance is that for women not on HRT even one drop of post-meno bleeding has to be investigated.

That really sucks.

My GP didn't tell me to stop the HRT, even though I was expecting her to.

I've been referred too but for a colposcopy and ultrasound, GP could see some 'wrong cells' on my cervix. I was called with an appointment within 10 minutes of leaving the docs.
my GP also mentioned that sometimes women are asked to come off HRT for 6 weeks but also said that often that's not an acceptable course of action for the patient.