Post menopause and bleeding

[Isabelle70]

As I had no menopausal symptoms and being 54 I had a blood test last September and I have gone through the menopause.
I was taking the mini pill until about November as it did help my skin but decided to stop taking it and see how my skin was, my skin is fine.
Today, I am losing blood, feels like it's a lot and have dull cramps.
I never suffered with any issues when I did have periods.
I am going to book in to see the Dr Monday, in the meantime has anyone experienced this?

My friend has - she was 58. Had an episode of very light post-menopausal bleeding - no cramps or pain. Referred to gynae under 2 week wait protocol. Scan showed thickened womb lining. Not on HRT. Had hysteroscopy and biopsies. All clear- has heart shaped uterus which was the reason lining looked thicker. Bleeding due to thinning of skin of vagina post-menopause. All very common apparently.

Consultant thought it could be polyp - said that is the most common reason for it, but it wasn't.

Just to say that blood tests are unreliable.
I had one at 52 and it said was post meno- but wasn't. Went on to have a few more periods.
As you've just stopped the mini pill it sounds very much like a real period.
Anything sinister is very unlikely as you've been on the mini pill but see your GP and they'll refer you for scan.
Cramping and a lot of blood loss like this is not usually how serious issues start- it's usually spotting after many months and usually years of no periods.

Thank you @LuluBlakey1 @JinglingSpringbells you have put my mind at rest. Feeling a bit let down regarding the blood test not being reliable, the Dr was very much yes you have been through it and no need to worry that you had no symptoms not everyone does.

If you are post-menpoausal, and as @JinglingSpringbells says it may be a period, try not to worry. My cousin is 56 and had a PM bleed too recently. It was a polyp. The consultant told her in 94% of cases it is absolutely nothing to worry about.

The point is if it's a period she is NOT post menopausal yet.

Post menopause is 12 months with no period.

If OP has been on the mini pill until 3 months ago, it stops ovulation is many women.

It can also take 3 months for ovarian function to resume.

@Isabelle70 The mini pill stops ovulation (depending on the type you were on.)

Younger women coming off the POP are advised it can take 3 months or longer for their cycles to resume.

You cannot know for sure you've reached menopause if you're using hormonal contraception like the pill, IUS (hormonal coil), contraceptive implant or contraceptive injection. This is because hormonal contraception can affect your periods.

This is from the NHS site ^

Also, the progesterone in some mini pills is similar to the TREATMENT for thickened uterine linings. You've not been taking estrogen which does make the womb lining thick.

That's what I said- IF she is post M. As @JinglingSpringbells said it may be a period and not PMB.

I have been on desogestrel for about the last 10 years and only had a couple of periods at the start and I can't remember the last one.

It would make sense that I am not post menopausal as I have had not one symptom, that's why I asked for a blood test as I thought by my age I should have had something going on. But on the other hand did think maybe the pill has masked it.

Well done for getting checked out. I had a PM bleed and it was an ovarian cyst which needed removing. You should be put on the 2 week cancer pathway, if you're not you need to remind them of the NICE guidelines. Don't be alarmed, you'll be sent for a scan and most of the time it's nothing sinister.

The 2 week pathway isn't used for women who are not definitely post menopausal. It's been 'relaxed' to 6 weeks for women who are using HRT (and who knows about contraception) as the likelihood of anything serious is tiny.
This is in the latest GP guidance.

I think part of the issue is that so many women have 'blips' on HRT that clinics are being swamped with women who don't need to be there .

Of course, there has to be some investigation, but the highest risk is women not on HRT who've not had a period for a long time and have other risk factors.

I have seen the Dr this morning and she is referring me for a scan, I am not in the UK so the process may be slightly different here. I can also go private so I have put a request into AXA.
In the meantime she confirmed I am post menopausal as my FSH level is 55.

I did say that I was found to be post menopausal with an FSH over 30 (cut off point) and carried on having periods for another 18 months. My consultant found it amusing and said it was an example to share with their students, showing how these tests can be inaccurate.

Not being in the UK makes a difference to what you're being advised and timescales. Europe and the rest of the world have a very different approach to HRT.

I hope all goes well for you x

I have my appointment with the gynaecologist tomorrow afternoon, it's all gone very quickly which is good but I do feel rather worried and trying not to think about it.

An update from me, I saw the Consultant twice, for ultrasound scan, biopsies and then a checkup and nothing untoward noted.
Here I am 7 months later and bleeding again, not a lot, very light for the last 6 days. I have been signed off from work with exhaustion and stress for 2 weeks and then a number of weeks on reduced hours.
The consultant did suggest a coil in January but I would rather not.

Following on from the above it’s now been 11 days and for the last 3 it’s been very heavy and changing sanitation protection every 2 hours. I have been on holiday and can’t wait to get home today to see a doctor or the consultant.
When I had periods they were never this bad.

Sorry you're going through this @Isabelle70. I had ongoing bleeding for about a year and in my case it was caused by a polyp and HRT. The bleeding continued -albeit more lightly - after the polyp was removed and only stopped when I changed my HRT from patches to gel. I hope you find answers and a solution soon.

@Itsasintokillamockingbird thank you. I have been able to book a consultant appointment for Friday afternoon which is a relief.
It was all clear with the scan and biopsy in February and I have not needed any HRT.

I have seen the consultant this afternoon and have a womb lining of 30ml . He has done an ultrasound, taken a biopsy and clot for review.
He has also put me on the list for a Hysterocopy under local with the coil to be fitted at the same time. I am a private patient in the Channel Islands so should not have to wait very long at all.
I also have a prescription of temazepam to take beforehand with other pain relief.
Feeling rather overwhelmed and trying not to worry. Also do not want to worry my Dd so will carry on as normal.

I have received a copy of my medical report and it has confirmed I have a very thickened cystic endometrium.

Have others had a hysteroscopy, biopsy and coil under local? Anything I should be aware of? Is it as uncomfortable as I have read?

It really is very individual and you will get very different experiences from whoever you ask.

I had a hysteroscopy with no local or anything and it was fine. It was no worse than a smear but my consultant took a lot of time. It was done privately with the plan of doing it with nothing (my preferred choice), add a local if needed and reschedule if necessary for a GA.

I hope you get on okay.

Thank you @JinglingSpringbells I am having the procedure done privately on Tuesday and have a prescription for temazepam to take beforehand.
Fingers crossed I sail through it:)

I had the Mirena fitted under local anaesthetic with temazepam, paracetamol and ibuprofen that certainly took the edge off there was only a slight snap feeling at one point.
However, now I am feeling really sorry for myself, I have been bleeding for a week, have constant whiteheads popping up on my chin and mouth area overnight and in the day.
I hope this all gets better as it’s feeling pretty rubbish at the moment.

It can take a while to settle but also correlation is not causation, so it's unlikely the mirena is causing the white heads. It could be something else stress etc. The mirena tends to (not always) have less side effects as it is localised in the uterus. It can take 3-6ish months to settle.

In the meantime I'd ask your GP to prescribe tranexamic acid, as that helps a lot with heavy bleeding, take it consistently and it should help.