Thickening of Endometrium

[raspberrymilkshake]

Hi , I’ve been on HRT for fours years and had a pelvic scan last week due to spotting I’m on 75mg Everol and 200mg Utrogestan.
Im so tired of it all , the Dr phoned today my Endometrrium is 4mm and he’d like me to have a Hysteroscopy, I’m just can’t find the correct balance with HRT all is good for a while then I start spotting . Does anyone know what thickness the Endometrium should be please ?

I think it’s something like below 4 after menopause. Are you taking continuous progesterone?

Are you using sequential HRT (a cycle) or combined continuous.
4mm is not thick, whichever.

on a cycle it can go up to 10mm or higher mid cycle then the bleed reduces it.

If you're on combined continuous anything over 4mm is sometimes queried (so that 5mm and over) but your scan report should show not just the measurement but what can be seen. Even a slightly thicker lining is not always an issue as it depends on what can be seen on the scan.

If you're using HRT on a cycle your GP should consider reducing your patch to 50mcgs or the Utrogestan to 300 mgs x 12 days.

This is all in the BMS guidance for the use of progesterone in HRT- your GP can check.

Hope you get sorted.

Thankyou , I’m on continuous HRT , I did email my meno Dr today and she advised reducing my patches to 62.5 & continue taking 200mg of Utrogestan , which means cutting the patches
in will be speaking to my GP tomorrow , but I don’t where it’s going to go from here.
I dread the thought of a Hysteroscopy it fills me with worry .

@raspberrymilkshake Are you definitely post menopause? So many women on this forum are using continuous HRT too soon (often 'pushed' by a GP into this) then they experience odd bleeds.

The criteria for continuous are aged over 54 and no natural period for 12 months at least - otherwise it's a sequential HRT.

If your periods had not stopped for good 4 years ago, you may still be having natural cycles that are not controlled by HRT.

I just had this scenario. Mind was 7mm. I had a hysteroscopy and they removed a polyp. I watched them on the screen... fsscinating. My biopsy came back as normal and I've been told i can just continue with the hrt.
Good luck!!

Thanks for your replies I’m definately post menopausal . Rattai did you change your HRT dosage ? I definately have a fibroid but apparently it’s tiny . How did you find the Hysteroscopy ? Was it very painful? Did you have a GA?
Im really nervous about the whole procedure

I haven't had to change my dosage. I was just told to stop taking it for the 2 weeks leading up to the procedure.
It was uncomfortable. Not going to lie. i had a local anaesthetic injevtion in cervix and it was totally bearable.
I didnt want the hassle of a GA

Mine was 8mm 3 years post menopause and on HRT. Test was barbaric without any pain relief! 😖🤯🤦🏽‍♀️ thankfully all tests were clear. But I wouldn't have the test again unless it was with some form of anaesthetic!

If you want it done under GA you can just ask for that. That’s what I did, I had to wait an extra 10 days but that was worth it for my peace of mind, I wasn’t prepared to have them doing it whilst I was awake. Results took 8 days and it’s all fine.

Thankyou , since reducing the patch dosage the spotting has stopped . I’m away at the moment but my Dr has put me on a 2 week pathway
My pelvic scan looked ok the Dr said it could be the fibroid causing bleeding

How painful is having an injection into the cervix I’m so worried but appreciate honesty

Reading with interest. I didn’t want hysteroacopy and was fed up with periods. In the end I just stopped all hrt (53) and periods stopped instantly. I feel much better. I plan to go back on a new hrt in the future for the benefits

Quite honestly just a sharp scratch and then nothing.
Like a pinch. They can also offer you gas and air if you want it.
I just wanted the appt and procedure as soon as possible. I had the polyp removed and a biopsy of the lining. All have come back clear.
Good luck with yours. Choose whatever you think you need to get it done .

I had the same procedure after a thick lining after menopause. The staff were so kind and amazing telling me what they were doing as they did it and yes there was a screen if you wanted to watch. I didn’t… they did remove some lining which felt like a strong pinch. To be honest it was fine- a tad uncomfortable but it really was ok and I didnt want all the hassle of a general- though that wasn’t actually offered.

Thankyou for your reply , I’m just wondering what happens after the procedure and all going well will I be afvised to stop HRT
Im currently in a hot climate and my ankles are swollen this is nothing new since starting HRT
We had a 2 hour car drive and my ankles are swollen unless I wear compression socks

This is coming off topic but I’m just wondering if anyone else experiences this ? It is something that I will be discussing with my Dr

I had a hysteroscopy last year and it was really painful and I had bad cramps afterwards.

Make sure you take painkillers and have someone else to drive you home afterwards.

Off topic but it’s your topic so - you could take a break from the hrt. I am a huge fan of it - no agenda here. But maybe it’s time to see what’s going on without it and then try a new product. I had large polyp and it went when I stopped

Hi Newgirls, I’m feeling so disappointed that it’s one thing after another over 4 years I’ve had 3 pelvic scans , my meno Dr has tweaked the dosage it seems ok for a while then spotting back for pelvic scan . Swollen ankles which I don’t know if it’s related or something else I’ve really had enough
Im currently on 75 Everol I’m just wondering if lowering the dose would be just as beneficial once I get my test results back .
The joys of getting older 🙈

the oestrogen feeds the womb lining doesn’t it? So if it’s causing you issues yes why not reduce?

You need to see your GP on this.
Swollen ankles can be a sign of all sorts, such as heart or kidney issues. Have you had any tests from your GP for this?

No I haven’t but it’s something that I have to see about . It’s been going on a while even going out today my ankles and legs looked puffed up but once I’m back indoors they go back to normal

I have reduced my Everol with the advice from my meno Dr , the spotting has stopped
I had a text today to phone to book an appointment with a Gynaecologist, I did phone and it’ll be a phone consultation to start , is this usual ?

Phone chat seems ok to start? No need for an internal or scan or anything to talk dosage and symptoms

Well I’m hoping that’s the case when the Gynaecologist phones me as the thought of an hysteroscopy terrifies me
The spotting has stopped now since lowering my estrogen patch to 62,5 , when I cut the patch it’s a rough guess of dosage .

I had a hysteroscopy yesterday and found it very difficult I have to say. Had painkillers in advance and a local anaesthetic in the cervix. I’ve heard that it’s different for everyone, however for me it was painful, they kept saying that I could say stop at any time. I wanted to get the polyp removed and the little biopsy done and could stand it with the little camera in the uterus but when they wanted to open the cervix a bit more for the device to remove the polyp that was enough for me. Almost fainted and my blood pressure went right down. Booked in for a general anaesthetic now. Like I said, some women seem fine with it, however I don’t really understand how a cervix can take hours to dilate in childbirth yet they expect to open it 4-5 inches within 10 minutes for a hysteroscopy. Any midwifes on here feel welcome to educate me.