Utrogestan and thickened womb lining - anyone experienced this?

[ThePolarBearWhoLostHisCrown]

So when I was prescribed HRT (gel) less than a year ago I was also prescribed Utrogestan which was supposed to keep the lining of my womb thin, as I understood it. I've had a few bleeds post-menopause and a week ago today had a GP consultation where she expressed concern and referred me for a TV ultrasound. I was contacted the next day and went for the scan the following day. I was told to wait a week to speak to my GP about the results. The next day I had 3 missed calls from the hospital, when I called them back I was told I needed to speak to my GP. She called the next day (Friday) to tell me that my womb lining was thick and I would be referred under the 2ww. This afternoon I received a call from the hospital with an appointment for another TV ultrasound and an appointment with a consultant. I'm reeling from how fast this has moved on and terrified about what this means. Well, I know what it means, my GP told me I was being referred because of the cancer risk. Has anyone else had this and what was the outcome please? I'm really scared.

Too late to edit to add that the appointment is tomorrow. Oh, past midnight - so it's now today.

good luck for your appointment today.
I have got a hysteroscopy today for similar reasons. I know it is easy to say, but try not to worry. Endomoetrial thickening is actually quite common, and a lot of the time does not mean it has become cancerous. The fact thay are checking it out quicky is good because it means whatever is happening can be dealt with. I recently read some statistics which showed that since the increase in HRT use of the past few years there has been a 40% increase in rates of referral to gynae for investigation of post menoppausal or unscheduled bleeding, however the rates of diagnosis of actual endometrial cancer remain the same - this means that HRT can quite often trigger unscheduled bleeding but most of the time this is not due to endometrial cancer. If everything comes back clear they will discuss a change in HRT regime with you.
Hope today goes ok for you.

If you're not post menopausal the lining will be thicker anyway even using HRT the way you are.

Obviously we don't know your full medical history or where you are in peri or post meno but your GP ought to have taken all of that into consideration.

Continuous HRT is for women aged 54+ or who've not had a natural period for 12 months at least.

If you start this regime too soon, that's why bleeding happens.

At your appointment you need to discuss your own periods/ no periods in detail.

If you had any bleed in the 12 months before starting the HRT, you weren't classed as post menopausal and should have been using sequential.

Good luck with the appt.

@cutefluffyunicorn Thanks for your reassurance, your post has really helped put things in perspective. I hope your appointment goes well today too x

@cutefluffyunicorn How did your hysteroscopy go? I have to have one following today's consultation, plus a biopsy. They tried to do the biopsy today but I have a polyp in the way which they tried to remove and it was all too painful. My hysteroscopy will be done under ga. I've had one before and that was ga too. The consultant was very reassuring. My womb lining is 9mm.

It’s quite common when using HRT and they are checking to make sure. It may be that your HRT prescription dose needs adjusting.

On femiston 2mg & I have thickness of the womb, gynaecologist keeps his eye on it, ultrasound sound once a year

I didnt have it in the end!

I was all psyched up for it, even dragged dh along to drive me home afterwards. Saw gynae consultant at start of appointment who reviewed my scan and history and discussed with me and then concluded I didn't need a hysteroscopy!

The issue had been I was still having bleeding on a continuous hrt regime, I wasn't concerned as I am most likely not post menopausal (changing to continuous was my choice as I feel better on it, but I knew the risks of bleeding) but this was flagged by a gp (not my usual one) at my latest HRT review in Dec, who wouldn't listen to my explanation and referred me for a scan. Scan thickness showed as 5.8. which would have been fine for sequential, but was over limit for continuous! Saw my own GP who agreed with me likely not an issue due to my own cylce still being active,she didnt want to refer straight for hysteroscopy as felt it was not needed, but also didn't want to just ignore guidelines, so she sent a guidance request to gynae to see if hysteroscopy was really needed or not (we both thought not) Gynae advice came back for urgent hysteroscopy. Fast forward to yesterday when I sit in front of Gynae consultant who then tells me hysteroscopy is in fact not needed! All slightly frustrating as it has made me quite anxious over the last 6 weeks, but to be honest glad it is all resolved.

Sorry to hear yesterday was a bit difficult for you. Sounds like it was painfull I hope you get your date for your GA hysteroscopy soon so you can put your mind to rest.

That's great news but it's a shame that some GPs don't seem better informed so women don't end up having the stress of being referred. Thankfully the consultant you saw understood!

yes, I agree.
The GP I usually see is great,very knoweldgable and very pragmatic and had the original review been with her I'm fairly sure this would not have happened. Unfortuately, due to the (stupid!) triage system the practice has now introduced you have to do the hrt review by completing info online which is then reviewed by whichever GP is triaging that day, which led to a ridiculous series of online messages back and forth with me trying to explain I wasn't concerned about the bleeding and felt there was a logical (non sinister) explanation for it, and her not really getting what I was saying, and that is where it all went wrong! Im definitely going to make sure my review in Dec this year is done by the right GP to save this faf again!
Obviously I appreciate the GP was only doing what she thought was safe and correct,and technically she did follow the BMS guidelines, but it was stress I could have done without as I am also just recovering from an epsiode of severe depression and anxiety - so this was not really what I needed!

Obviously I appreciate the GP was only doing what she thought was safe and correct,and technically she did follow the BMS guidelines

Except the guidance on bleeding doesn't apply to new users of combined continuous HRT (from what you've described.) Not sure how long you were on it.

no, I switched from sequential to contiuous 12 months ago, which was the issue. GP was saying that bleeding should have stopped by this point, which I understand, but my argument was it was being driven my natural cycle as I am not post menopausal! Ah well, I knew this may be an issue using continuous before menopause, so not to worry.

The issue is that GPs 'follow the rules' sometimes to the letter, whereas a consultant would look at the whole picture and be more flexible. Also, the measurement of the lining is a guide. The other issue is that the people doing the scans in the NHS aren't consultants to they can't make the call - they always pass it on to someone else.

I upped my HRT which led to bleeding, thickened womb lining and a hysteroscopy to investigate.

No problems were found and I'm not convinced that investigations are actually appropriate when clearly linked to HRT increases. I think the issue is that HRT is not properly researched so the current guidelines are not based on proper research.

It's a balance between catching women with real issues and those with none.

They allow 10mm for use on HRT if it's cyclical before doing invasive investigations. The stats for hyperplasia and cancer show most women had linings of almost 3 cms - 30mms.

The problem is there aren't enough consultants. The people doing scans can't make a good call so women end up in a system being passed from one person to another, taking weeks.