HRT and spotting

[Trixie2012]

Hi , I’m on Everol and 200mg Utrogestan, however I’ve never in 4 years found the right balance of HRT with spotting and scans for thickened Endometrium
Im going for yet another scan as my endometrium was 5.3 so I think a Hysteroscopy is needed
Im just wondering if anyone else is currently going through this and what progesterone your using

I’ve been reading up on Provera and apparently someone mentioned cancer and weight gain on the nice guideline
I’ve thought about the Mirena coil but some women don’t feel comfortable with it and some coils have been lost .

I take it just before bed, it does make me sleep deeper so I think I'm less tired than I was on 200, and I had a lot of nightmares to begin with, but that's calmed down. I think 300 is usually the highest, but I know 400mg can be used too.

You can either lower the estrogen or up the progesterone - that's usually the cause if no other worries from scan.

Never knew they worked on Sundays - good stuff.

They won't do a hysteroscopy there, on the spot, I'd assume.

The local NHS Gynaecology clinic where I live is twice a month . I’m hoping no Hysteroscopy
I’ll let you all know how I get on it’s also good to know if anybody else experiences what I’m going through ,

I was told the same, US with possible hysteroscopy. They did indeed do one there and then. I was totally unprepared, had no idea how painful it could be, and would never have one without GA again.

You can always refuse and ask for it to be rescheduled if you prefer- they can't force you.

It's very rare for women on HRT who have spotting to have endo cancer or cancerous changes (there are stats online for this and the number is tiny.)

Thankyou again for your reassuring words my nerves are in tatters this morning , as much as I don’t want to stop HRT I’m getting to the point that I’ve had enough .

Fingers xd.

I think rather than give up, if you can afford it, it may be good to see a private HRT expert t o discuss all the options and who will give you the time (usually 45 mins ) to talk it all through.

It can be all sorts of things. Your uterus can be very sensitive to estrogen and very un-sensitive to progesterone. Your body may not absorb progesterone well. As others have said, an alternative delivery method may be better for you. Are you significantly overweight? Body fat produces estrogen so you may have much more active estrogen if you are. It’s such a balancing act.

if they require a hysteroscopy please don’t fret. It’s amazing that we can have proper investigations on the NHS. It can save lives. 💐

I do have a private meno Dr , I’m going to book an appointment to see her after this

Hi , I had a pelvic scan and my Endometrium lining has reduced to 4.5 which is great news , reducing the patch from 75 to 62.5 has worked .
I seen an Obstetrician she said although it should be 4 or less it’s nothing to worry about unless I experience bleeding then to return to my Dr .
I have one tiny fibroid and cysts around my cervix but she said it’s nothing to worry about but to continue on the 62.5 patches & 200mg Utrogestan
To say say I’m relieved and didn’t need a Hystereocopy is an understatement
Thankyou all for your support

That's wonderful, Trixie.

That's good and such a relief for you.

It does confirm what I've been told - that the measurement itself is not the be all and end all if it's hardly above the guidance. It's how it looks that's the important thing and if you're bleeding at all.

Yes you were right , it’s such a relief . Thankyou again for taking the time to reply to my posts and advice with reassurance

Now that OP knows all is well, I'd like to respond to this:

if they require a hysteroscopy please don’t fret. It’s amazing that we can have proper investigations on the NHS. It can save lives. 💐

It would be amazing if it was provided with adequate pain relief. It is appalling that this intrusive procedure is performed without, @bumbaloo. Mine came as a total shock to me, despite having read the patient information provided. Sometime afterwards I saw there's a campaign for pain relief to be provided, with many doctors horrified that it is regularly done without. A group of gynaecologists and anaesthetists are working on changing this. Meanwhile many women have frankly traumatising experiences.

The RCOG has produced a guide (August 24) which states clearly what women should expect which is adequate pain relief if they want it . However, a GA is not the default advice because it has its own risk, as well as costs.

I don't know if this is the advice you meant or something newer?

https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/outpatient-hysteroscopy-green-top-guideline-no-59/

I have to disagree here. A GA is not the default because of costs.

Every woman should have te right to request a GA and be given one.

My gynaecologist ( who performed mine) will only do them under GA for her private patients as the risk of extreme pain is so high. NHS she does it with nothing at all!

But there are risks to a GA (small, but they are there) as well as costs.
I didn't want a GA under any circumstances. I was offered one. It was private and I had a choice.
There has been a survey of women and 75% of women said they were ok without a GA. Obviously that leaves 25% but my opinion is a lot depends on the skill of the surgeon.