Post Menopausal Bleeding referral

[vxa2]

I have been referred on the 2 week pathway for investigation of post menopausal bleeding. I am 53, on HRT and have been experiencing bleeding since last week.

i have an appointment at the PMB clinic at Birmingham Womens’ Hospital this week. My understanding from what I have read is that I will have an ultrasound and then if the womb lining is above a certain thickness will need a biopsy and hysteroscopy. I would be grateful if anyone is able to give me a general idea of what to expect at the clinic. If I need further investigations would those be likely to happen on the same day? Experience of Birmingham Womens’ would be especially helpful. I felt OK at first but as the appointment approaches I’m feeling quite anxious. Thank you.

Anyone ?

It's very unlikely you will be investigated on the same day other than the scan. That takes about 5 mins and is less painful than a smear- small instrument, lube used, not fully inserted.

You may not see a gynaecologist - someone else may do the scan and send the info to a consultant.

You can always call them now to ask what's going to happen.

One thing to be aware of if it applies to you, is that it seems a lot of women are being put onto the wrong type of HRT (continuous combined which is for post menopausal women.) They sometimes experience bleeding (because it doesn't control the bleeding in women who still have some ovarian function.)

I’ve just gone through this. I’m not in the uk but the setup is similar here in Ireland. I had bleeding after changing my HRT. Last normal period for me was probably a decade before that!

GP initially tried doubling my progesterone but that didn’t work for long and bleeding resumed. She referred me to clinic. I saw nurse first for a history & gave urine sample, then an ultrasound tech did a vaginal ultrasound. Doctor then reviewed the results of the ultrasound with me. As there was nothing sinister in the scan & I was on the right progesterone dose, she recommended a mirena coil (this replaces the progesterone) They could put it in then and there in the unit or I could have my GP do it later. Other option was wait and see as she felt bleeding would settle eventually.

I wasn’t happy to wait as I’d been bleeding for around 6 weeks at that stage. I opted for them to fit the mirena as I figured they would do it better. The fitting was ok, they were very kind (all women TG) and communicated well throughout.

my bleeding did eventually stop after around a month - tapered off from a full on period type flow then went progressively lighter and eventually stopped.

While the experience was fine, I was a bit bemused that they weren’t at all concerned with the cause of the bleeding (attributed it to change in HRT from patch to gel). Once they saw clear scans, they were happy to send me on my way. On the plus side, I was happy that the investigation was thorough. They used a camera when fitting the coil & consultant supervised so she had a really good look at my cervix and uterus.

best of luck xx

Just been through this. Had an ultrasound and internal. Referral to Gyne. Nothing found, all healthy and a change to my HRT was made.

I've been on the 2 week pathway twice in less than a year for the same. They did ultrasounds and a biopsy, I had to have a blood test and then a hysteroscopy. I didn't ever see a gynaecologist because every test came back negative. I know the NHS has problems but my experience is that the 2 week pathway is one are where many hospitals are functioning well. I hope that everything comes back negative for you.

Thank you for sharing your experiences. I appreciate it.