Post menopausal bleeding

[annonymousnamechange]

Had some bleeding in June so onto the 2 week pathway. NHS very efficient, hysteroscopy under GA and everything came back clear, job done. Consultant told me to wean off HRT which I've done and had the joy of many of the symptoms again. Last night found I was bleeding. Again. Looks and feels like a period. I know the answer is yes but do I really need to go thro the whole 2 week palaver again having been given the all clear 4 weeks ago? Im 59 and I think my last official period was in 2021. Thank you!

Poor you. I hope you don't have to go through it again...
I am also 59. Why did you have to wean yourself off hrt? There are so many different types. Of course, you may have wanted to.

The British Menopause Society has a detailed guide on this. They say that there is no need for a repeat hysteroscopy for at least 6 months if the previous recent one was all clear. Presumably they did a biopsy at the time and you have seen the results?

I don't understand the weaning off HRT. Is this because you had some bleeding or was it something to do before the procedure?

Are you back on HRT now?

Were you due a bleed on HRT? What type were you using?

What was the consultants reason for you to wean off?

Thanks, ill look up the menopause societies guidelines as I think they'll be helpful in possibly requesting HRT again. I was on 100 mg urogenstan and 3 pumps of oestragel at night. Consultant gynae said oestrogen was causing a thickened lining so to stop. However happy to reconsider if I can evidence this. Took biopsies and removed some fibroids and got the letter giving me the all clear about 10 days later. More than happy if I don't have to have another hysteroscopy as they have to do it under GA

I had bleeding at age 59. I was told it was vaginal atrophy, which was a fob off as it turned out. Eventually I was diagnosed with a Granulosa Cell Tumour. I had a radical hysterectomy, removal of the tumour and omentum. That was 11 years ago. Don’t mess about get another referral.

@annonymousnamechange There are two sources of info from the BMS. One is how to deal with post menopausal bleeding but the other is the use of progesterone in HRT and endometrial protection (I've linked to that one several times including this week- so do a search?)

Your consultant appears to have been dismissive.
There's absolutely no need to stop HRT you just need to get the ratio of estrogen - progesterone right.

I wonder why they didn't suggest this? It's not very caring, is it?

The BMS guidance is that for larger doses of gel (3 pumps is higher than 2) you use 200mgs Utrogestan a day.

This is straightforward and any gynae ought to have talked to you about this.
Your GP should know too if they have read the guide (it is for GPs!)

You could try reducing your gel to 2 pumps or consider the Mirena coil- two options your consultant should have talked about.

I hope you get it sorted.

You don't have to have a GA for a hysteroscopy unless it's your choice.

@Rabbitrabbitrun Sorry to hear you were misdiagnosed but OP has had investigations just a couple of weeks or so back. Maybe you weren't offered those? They don't tend to repeat it soon afterwards.